title: A free retinal pigment epithelium-choroid graft in patients with exudative age-related macular degeneration: results up to 7 years.
abstract: OBJECTIVE
  To report and analyze long-term best-corrected visual acuity (BCVA) outcomes following a free autologous retinal pigment epithelium (RPE)-choroid graft translocation in patients with exudative age-related macular degeneration (AMD).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  
  
  
  METHODS
  Institutional.
  
  
  METHODS
  One hundred and thirty consecutive patients (133 eyes) with AMD underwent RPE-choroid graft translocation between October 2001 and February 2006. All patients had a subfoveal choroidal neovascular membrane with or without hemorrhage and/or an RPE tear. All were either ineligible for or nonresponsive to photodynamic therapy, the standard treatment at the time of surgery.
  
  
  METHODS
  Data collection included preoperative and postoperative visual acuity measurements, fundus photography, fluorescein and indocyanine green angiography, and microperimetry.
  
  
  METHODS
  Postoperative BCVA.
  
  
  RESULTS
  The mean preoperative BCVA was 20/250. Four years after surgery, 15% of the eyes had a BCVA of >20/200, and 5% had a BCVA of ≥20/40. One patient achieved a BCVA of 20/32, which was maintained at 7 years after surgery. Complications consisted of proliferative vitreoretinopathy (n = 13), recurrent neovascularization (n = 13), and hypotony (n = 2).
  
  
  CONCLUSIONS
  RPE-choroid graft transplantation may maintain macular function for up to 7 years after surgery, with relatively low complication and recurrence rates. Retinal sensitivity, BCVA data, and fixation on the graft suggest that the graft, rather than simply the removal of submacular hemorrhage and/or choroidal neovascular membrane, was responsible for the preservation of macular function. This surgery may be an alternative for patients with AMD who cannot undergo other standard treatment.
authors: Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands. e.vanzeeburg@oogziekenhuis.nl
authors: Elsbeth J T
authors: EJ
authors: van Zeeburg
authors: Kristel J M
authors: KJ
authors: Maaijwee
authors: Tom O A R
authors: TO
authors: Missotten
authors: Heinrich
authors: H
authors: Heimann
authors: Jan C
authors: JC
authors: van Meurs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017690:Cell Transplantation; D002829:Choroid / Q000637:transplantation*; D015331:Cohort Studies; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology; D014821:Vitrectomy
chemical_list: D007208:Indocyanine Green