Successful macular translocation with temporary scleral infolding using absorbable sture

Area of Science:

• Ophthalmology
• Retinal Surgery
• Neovascular Eye Diseases

Background:

• Subfoveal choroidal neovascularization (CNV) from age-related macular degeneration (AMD) or ocular histoplasmosis syndrome (OHS) poses a significant challenge to preserving visual acuity.
• Macular translocation surgery aims to move the fovea off the CNV to improve outcomes.

Purpose of the Study:

• To evaluate the efficacy of macular translocation with temporary scleral infolding (MTSI) in patients with small subfoveal CNV.
• To assess the stability of retinal translocation and associated visual outcomes and complications.

Main Methods:

• A prospective, nonrandomized clinical trial involving 10 consecutive patients undergoing MTSI.
• Temporary scleral infolding was created using absorbable polyglactin sutures.
• Measurements included retinal translocation distance and stability, corneal topography, visual acuity, and complication rates.

Main Results:

• Median retinal translocation of 1,700 microm (range, 680-3,200) was achieved and remained stable after scleral infolding resolved.
• Induced corneal astigmatism resolved postoperatively.
• Visual acuity outcomes varied, with 3 patients gaining >2 lines, 2 stable, and 5 losing >2 lines.

Conclusions:

• Temporary scleral infolding is an effective technique for MTSI, achieving stable retinal translocation comparable to other methods.
• The induced corneal astigmatism appears to be transient and resolves.
• MTSI using temporary scleral infolding presents a viable surgical approach for subfoveal CNV.