Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration: long-term results.
OBJECTIVE
To report the practicability and efficacy of autologous iris pigment epithelium (IPE) translocation in exudative age-related macular degeneration (ARMD) over 1 year.


METHODS
The consecutive interventional case series included 56 patients with exudative ARMD. During vitrectomy the submacular neovascular membrane (CNV) was removed and IPE cells, harvested from a peripheral iridectomy, were injected into the submacular space. Included were patients with subfoveal occult CNV (11 eyes), classic CNV (10 eyes), mixed CNV (17 eyes), CNV with a pigment epithelial detachment (13 eyes) or CNV with a hemorrhage (5 eyes). Outcome measures were visual acuity, foveal fixation, size of CNV and rate of recurrence based on fluorescence angiographic imaging.


RESULTS
All patients underwent successful surgical removal of the CNV with consecutive subretinal IPE injection. Visual acuity was better than 20/100 in 19 patients preoperatively and in 18 patients postoperatively. A visual acuity of 20/100 or less was found in 37 patients preoperatively and in 38 patients postoperatively. Mean preoperative visual acuity (1.0+/-0.3 logMAR units) did not change significantly after 1 year (1.0+/-0.3 logMAR units). Ten eyes (18%) developed a recurrence. Fixation within the surgically denuded area could be demonstrated in 25 eyes (45%).


CONCLUSIONS
Autologous IPE translocation for ARMD over one year can preserve foveal function on a low level, but cannot improve visual acuity. IPE translocation is technically feasible with a low rate of complications. Continued research seems justified to improve functional outcome.
Department of Ophthalmology, University of Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany. alappas2000@yahoo.com
Alexandra
A
Lappas
Andreas M H
AM
Foerster
Andreas W A
AW
Weinberger
Silke
S
Coburger
Norbert F
NF
Schrage
Bernd
B
Kirchhof
D000368:Aged; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000503:physiopathology; D006801:Humans; D007498:Iris / Q000637:transplantation*; D008137:Longitudinal Studies; D008268:Macular Degeneration / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D010857:Pigment Epithelium of Eye / Q000637:transplantation*; D010865:Pilot Projects; D014182:Transplantation, Autologous; D016042:Transplantation, Heterotopic; D016896:Treatment Outcome; D014792:Visual Acuity