Macular translocation with chorioscleral outfolding: an experimental study

Area of Science:

• Ophthalmology
• Surgical Innovation
• Retinal Surgery

Background:

• Macular translocation by chorioscleral infolding is a proposed surgical treatment for exudative age-related macular degeneration.
• This technique is associated with unpredictability and significant complications.

Purpose of the Study:

• To evaluate a novel surgical technique: macular translocation with chorioscleral outfolding secured by neurosurgical clips.
• To compare the efficacy and predictability of this new method against traditional infolding techniques.

Main Methods:

• A prospective interventional study involving human cadaver eyes and live pigs.
• Chorioscleral infolding and outfolding procedures were performed on cadaver eyes to measure wall shortening.
• Three scleral shortening methods (sutured infolding, clipped outfolding, radial clipped outfolding) were tested in pig eyes to measure foveal translocation.

Main Results:

• Chorioscleral outfolding in cadaver eyes resulted in greater wall shortening (3.0 mm) than infolding (1.6 mm).
• Radial chorioscleral outfolding with clips in pigs achieved the greatest mean foveal translocation (3386 microm).
• Radial clipping minimized undesirable retinal folds and globe deformation compared to sutured infolding.

Conclusions:

• Radial chorioscleral outfolding secured by clips is a more predictable and effective method for macular translocation.
• This technique successfully translocates the macula while preventing problematic retinal folds.
• The findings suggest improved outcomes for exudative age-related macular degeneration surgery.