MACULAR TRANSLOCATION WITH SCLERAL IMBRINCATION. THREE YEARS OF EXPERIENCE

Carlos Mateo (Barcelona)

Subfoveal choroidal neovascularisation (CNV) is one of the most important cause of central vision loss and reading ability disturbance. The most frequent causes of this pathology are, Age Related Macular Degeneration (ARMD) and high myopia followed by the idiopathic cases.

These different entities show different peculiarities in relation to the age of appearance ,extension of the neovascular process, and the incidence of bilateral affection. In 1998 a new surgical technique was reported:Macular translocation by means of scleral imbrincation.

We are going to show our experience of prospective study using macular translocation with scleral imbrincation. Between June 98 and July 99 we treated 39 eyes of 39 patients. In the ARMD group and 79 eyes of 79 patients in the myopia group of patients. With a minimum follow up of 2 years we obtained the following results: In the ARMD group only 8 cases (20.5 %) mantained positive reading ability of 12 point arial sentences at this 2 years minimum F-Up. Mean pre-op VA was 20/160 (0.125) and mean post-op VA was 20 /125 (0.16) . The VA was >/- 20/64 in 20.5 % of the treated eyes. Recurrence rate was 31 %, and retinal detachment was observed in 4 cases (10.2 %) and required other treatments. We observed 2 macular folds (5 %) and no macular hole formation.

In the myopia group, mean pre-op VA was 20/125 and at one year mean post-op VA was 20/70 (0.3). At minimum two years F-Up mean VA was 20/80 (0.25) and VA was >/- 20/70 in 43 % of the treated eyes . Reading ability of 12 point arial sentences at a normal distance (33cm) was obtained in 59 % at one year and in 43 % at two years . In 20.5 % macular translocation was considered insufficient and 8.8 % of the treated eyes showed a post-op retinal detachment that requierd addicional treatments. Recurrence rate was 28 % at two years.

In the idiopathic group we treated 7 eyes of 7 patients with a minimum F-Up of six months .Mean pre-op VA was 20/126 and mean Post-op VA was 20/32 . Reading ability of 12 point arial sentences was obtained in all but one patient (85 %).

Macular translocation offers a realistic approach to recover central vision and reading ability.


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