Macular translocation--an innovative treatment for macular degenerative diseases.

BACKGROUND: Age-related macular degeneration with subfoveal choroidal neovascularization (CNV) is difficult to handle with any treatment modality so far. Macular translocation is an innovative surgical approach to this disease.

METHODS: The "full" macular translocation comprises phacoemulsification, complete vitrectomy, artificial retinal detachment, 360 degrees retinotomy, removal of the CNV, translocation of the neurosensory retina, and endotamponade with silicone oil. The "limited" macular translocation is accomplished by partial retinal detachment and scleral imbrication. The CNV can be removed during the operation or ablated by a laser postoperatively.

RESULTS: Full macular translocation was performed on 3 eyes, and upward macular displacement was achieved from 10 to 45 degrees. Limited macular translocation was performed on 2 eyes, and downward macular displacement was achieved from 350 to 900 microns. One eye had visual improvement, 2 eyes remained stationary, and another 2 eyes had worse visual acuity postoperatively. No proliferative vitreoretinopathy occurred in any of these eyes.

CONCLUSION: Macular translocation can relocate the macula to a healthy adjacent retinal pigment epithelium-choroid bed and is a promising surgical treatment for macular degenerative disorders. Further trials are mandatory to evaluate its benefits.