Retinotomy and foveal translocation for surgical management of subfoveal choroidal neovascular membranes.

PURPOSE

To report a surgical procedure for excising subfoveal neovascular membranes and translocating the fovea in an attempt to maintain the function of the sensory retina to preserve central vision, based on the technique of macular relocation.

METHODS

Three patients with subfoveal neovascular membranes underwent surgery for the creation of a nearly 180-degree retinal flap, removal of neovascular tissue, and reattachment and rotation the retina with translocation of the fovea over functional pigment epithelium.

RESULTS

In one patient with age-related macular degeneration, best-corrected visual acuity improved from 20/200 preoperatively to 20/20 postoperatively. A second patient, also with age-related macular degeneration, experienced a worsening of best-corrected visual acuity from 20/700 to 20/ 2,000. In the third patient, with myopic degeneration, best-corrected visual acuity improved from 20/700 to 20/70. Complications included the development of epimacular proliferation in two eyes and retinal detachment and neovascular glaucoma in one eye.

CONCLUSION

The technique of foveal translocation has the potential for restoring central visual function in certain patients with subfoveal neovascular membranes.