Macular Translocation – First Experience
Doležalová J.1, Rusňák Š.2
1 Oční klinika JL Nové Butovice, Praha, primář MUDr. Ján Lešták, CSc. 2Oční klinika LF UK a FN, Plzeň, přednostka doc. MUDr. Renata Říčařová, CSc. |
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Summary:
The age related macular degeneration (ARMD) is the most common cause of the
central visual acuity loss in persons of agemore than 60 years in the well developed
countries. Rotation of the macula is nowadays a progressive method of choice of
treatment of the exsudative form of ARMD. The aim of this surgical technique is
to relocate the neuroretinal epithelium of the central region of the retina to
a position situated outside the border of the subfoveolar lesion.
Three eyes of three patients (2 woman and one man) were operated on during the
period between March and May 2001 at the Department of Ophthalmology of the
School of Medicine, Charles University in Pilsen. The method used was the scleral
imbrication, which belongs to methods designated as “limited translocation”. The
mean age of the patients was 62 years and the follow up period was 2 years. After
the surgery the relocation of the fovea was observed in all three eyes. In two eyes,
the postoperative period was complicated by tractional retinal detachment that
occurred three weeks after the surgery as a consequence of progressive proliferative
vitreoretinopathy (PVR). Both eyes with the retinal detachment were
re-operated. In both of them, the repeated pars plana vitrectomy, epiretinal
membranes removal with relaxing retinectomy was performed and after maximal
mobilization of the retina, the silicone oil implantation followed. In the second
patient, the postoperative period was complicated by elevation of the intraocular
pressure and a radial retinal fold running from the encircling buckle indentation
up to the macula. Slightly improved function was noticed only in the first patient
after following cataract surgery with intraocular lens implantation. In the two
other eyes, as noticed at the last follow up check, the postoperative complications
caused severe decrease of the central visual acuity although the retina remained
attached.
Macular translocation procedure is in stage of development and its surgical
techniques are being further modified. The risk of postoperative complications
with profound loss of central visual acuity corresponds to the level of the technical
difficulty and extent of surgical intervention.
Key words:
age related macular degeneration, macular translocation
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