Surgical removal of large subretinal neovascular membranes: results and complications.

Over the period from June 1992 to January 1994, six subretinal neovascular membranes were removed in our department. In five patients the damaged membranes were caused by age-related macular degeneration and in one patient the cause was choroiditis of unclear etiology. The diameter of the membranes ranged between 3 and 20 mm. The largest membrane was removed translimbally after previous lensectomy. In all patients internal silicone oil tamponade was performed. Subretinal hemorrhage was the most common peroperative complication observed. Early postoperatively, transitory corneal edema and serofibrinous reaction were recorded in some patients. Cataract formation in connection with the silicone oil tamponade, chronic uveitis, formation of epi- and subretinal membranes, retinal pigment epithelium and choroidal atrophy were also subsequently observed. Relevant additional operations were performed with the exception of one patient with internal silicone oil tamponade and cortical cataract who refused all further procedures. After a follow-up period of 24-36 months, one eye atrophied. In one eye retinal detachment in one large subretinal membrane, in one atrophy of the pigment epithelium and in another epiretinal membranes under silicone oil were present. The visual acuity achieved is 0 in two eyes and it ranged between light perception and 0.5/60. Removal of large subretinal neovascular membranes is feasible, but the results are not justified by the surgeon's effort and the patient's psychic stress.