Visual results after submacular surgery for neovascularization in age-related macular degeneration

Submacular membranectomy has been proposed as a treatment option for subfoveal choroidal neovascular membranes (CNVMs). The authors reviewed the visual outcomes of patients who underwent surgical removal of subfoveal CNVMs caused by age-related macular degeneration (ARMD).

Thirty-eight patients (38 eyes) were retrospectively reviewed. Selection criteria included: (1) the presence of a well-demarcated subfoveal CNVM on fluorescein angiography; (2) best-corrected Snellen visual acuity reduced to the level of 20/200 or worse; and (3) no other eye disease that could compromise visual acuity. Pars plana vitrectomy, retinotomy, and membrane removal were performed to remove the subfoveal choroidal neovascular complex with minimal disruption of the surrounding tissues. A significant change was defined as a two-line difference from best-corrected preoperative visual acuity on the Snellen chart.

At 3 months postoperatively, 7 (18.4%) of the 38 eyes had improved, 8 (21.1%) of the eyes had worsened, and 23 (60.5%) of the eyes had remained unchanged. The final visual acuity improved in 8 (21.1%) of the eyes, worsened in 11 (28.9%) of the eyes, and remained unchanged in 19 (50%) of the eyes. The average follow-up time was 632 days.

The authors employed a minimally invasive approach to the removal of CNVMs in ARMD. Nevertheless, the resultant visual acuity was often unsatisfactory. Therefore, the authors recommend not operating on ARMD-associated subfoveal CNVMs with the current technology.