Long-term results after limited macular translocation surgery for wet age-related macular degenerationReport as inadecuate




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Purpose

To evaluate the long-term results of limited macular translocation LMT surgery with radial chorioscleral outfolding in patients with wet age-related macular degeneration AMD and subfoveal choroidal neovascularization CNV. In addition, to identify the factors associated with the final best-corrected visual acuity BCVA.

Methods

The medical records of 20 eyes of 20 consecutive patients 65.2±9.8 years who had undergone LMT for the treatment of wet AMD and were followed for at least 5 years, were reviewed. The surgical outcomes including the BCVA, degree of foveal displacement, and complications were recorded.

Results

The mean foveal displacement was 1332 ± 393 μm after the LMT. The CNV was removed in 16 eyes and photocoagulated in 4 eyes. The mean preoperative VA was 0.83 ± 0.33 logMAR units which significantly improved to 0.59 ± 0.37 logMAR units at 1 year after the surgery P = 0.015. This BCVA was maintained at 0.59 ± 0.41 logMAR units on the final examination. The final BCVA was significantly correlated with that at 1 year after the surgery r = 0.83, P<0.001. Multiple linear regression analysis showed that the final BCVA was significantly correlated with the BCVA at 1 year after the surgery P<0.001, a recurrence of a CNV P = 0.001, and the age P = 0.022.

Conclusions

LMT improves the BCVA significantly at 1 year, and the improved BCVA lasted for at least 5 years. These results indicate that the impaired function of the sensory retina at the fovea can recover on the new RPE after the displacement for at least 5 years. The ability to maintain good retinal function on the new RPE for a long period is important for future treatments of CNVs such as the transplantation of RPE cells and stem cells.



Author: Hisaaki Oshima, Takeshi Iwase , Kohei Ishikawa, Kentaro Yamamoto, Hiroko Terasaki

Source: http://plos.srce.hr/



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