Macular translocation with chorioscleral outfolding: 2-year results.
OBJECTIVE
To evaluate the results of macular translocation with radial chorioscleral outfolding in patients with subfoveal choroidal neovascularization (CNV) and to identify factors associated with decreased postoperative visual acuity.


METHODS
Retrospective interventional case series.


METHODS
Twenty-seven consecutive patients with surgically treated subfoveal CNV were operated on and followed for more than 2 years. Macular translocation with radial chorioscleral outfolding was performed using titanium clips. Surgical outcomes including visual acuity, foveal displacement, surgically induced astigmatism, and complications were recorded. Factors associated with decreased visual acuity postoperatively were identified by multiple logistic regression analysis.


RESULTS
Foveal displacement ranged from 349 to 3391 (median, 1576) microm. Surgically induced astigmatism ranged from 0 to 3.0 (median, 0.5) diopters. Visual acuity after surgery improved in 19 of the 27 patients (70.4%; median, 5 lines), but in 14, final vision ultimately decreased from the best postoperative level. Final visual acuity improved from the preoperative level in 11 patients (40.7%), remained unchanged in seven (25.9%), and decreased in nine (33.3%). In our series, the mean preoperative vision was 20/174, the best postoperative visual acuity was 20/74, and the mean final vision was 20/167. Factors associated with a decrease in postoperative visual acuity included the postoperative enlargement of CNV.


CONCLUSIONS
Macular translocation with radial chorioscleral outfolding improved or stabilized the vision in 66.7% of patients with subfoveal CNV over the course of more than 2 years. Closing the CNV or preventing its further growth is required to maintain a better postoperative visual acuity.
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan. mkamei@ophthal.med.osaka-u.ac.jp <mkamei@ophthal.med.osaka-u.ac.jp>
Motohiro
M
Kamei
Yasuo
Y
Tano
Toru
T
Yasuhara
Masahito
M
Ohji
Hilel
H
Lewis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000601:surgery*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000503:physiopathology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology