Improvement in near visual function after macular translocation surgery with 360-degree peripheral retinectomy.

BACKGROUND: Information is limited on how specific near-vision skills are impacted by therapies such as macular translocation surgery with 360-degree retinectomy (MT360) for age-related macular degeneration (AMD).

METHODS: Standardized tests of near vision were given to 25 consecutive patients with AMD who met entry criteria for this study, preoperatively and 6 and 12 months after MT360. Tests included: near acuity with the Lighthouse chart, timed reading speed using Sloan cards, contrast sensitivity, and color vision. Distance acuity was measured using Bailey-Lovey charts. Measures of preoperative visual function were analyzed to identify those predictive of visual outcomes.

RESULTS: Distance acuity was 20/80 or better in 52% of patients at 12 months after surgery, and mean acuity improved from approximately 20/125 preoperatively to approximately 20/100 at 12 months. Mean near acuity improved from 3.2+/-2.5 M before surgery to 1.5+/-1.0 M at 12 months (significant change of -1.5+/-2 M, P<0.001). Gain of greater than five numbers in contrast sensitivity at 12 months was also significant ( P<0.001). Mean reading speed improved from 41+/-31 words per minute (wpm) before surgery to 67+/-44 wpm at 12 months (significant gain of 25+/-33 wpm, P=0.001). Preoperative distance acuity, near acuity, and reading speed were each predictors of postoperative near visual function.

CONCLUSION: Standardized testing of near visual function provides important predictive and functional outcome data for MT360. MT360 significantly improved near visual function (including near acuity, reading speed and contrast sensitivity) in patients with subfoveal lesions from AMD in the second eye.