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[5-years' experience with transvitreal extraction of subretinal neovascular membranes]
Abstract:
Over the period between June 1992 and November 1997, 15 subretinal neovascular membranes were removed in the Department of Ophthalmology of the Comenius University in Bratislava. The age of patients ranged between 57 and 72 years. In 13 patients the membrane was caused by age-related macular degeneration, in one patient the cause was choroiditis of unclear etiology and in one patient the membrane was caused probably by age related changes combined with myopic changes in the macular region. In three eyes only subretinal membrane was present. In all other eyes were also subretinal haemorrhages, hemophthalmus, or retinal detachment present. The visual acuity ranged between light perception and 1/50. After membrane removal the retina was tamponated by silicone oil in 10 eyes and by expanding gases in four eyes. In one eye peroperatively occurred profuse bleeding from choroidal vessels and this procedure was interrupted. The follow-up period ranged form 5-52 months. During this period in nine patients were performed additional 12 surgical procedures. The visual acuity achieved is 0 in three eyes and in other eyes it ranged between hand movement and 5/50. Two eye atrophied. In one eye retinal detachment is present. Three eyes are still filled with silicone oil. In two of them the tamponade will be probably permanent. In nine eyes large areas of retinal pigment epithelium atrophy are present and in two eyes also subretinal fibrous membranes are present.
Insights
Surgical removal of subretinal membranes, often caused by age-related macular degeneration, yielded variable visual outcomes. Post-operative complications and visual acuity results highlight the challenges in treating these conditions.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Degeneration
Context:
- Subretinal neovascular membranes pose a significant challenge in treating vision-threatening retinal conditions.
- Age-related macular degeneration is a primary cause of subretinal membranes in older adults.
- Surgical intervention for subretinal membranes involves complex procedures with potential for complications.
Purpose:
- To evaluate the outcomes of surgical subretinal membrane removal.
- To assess the visual acuity results and complications following the procedure.
- To analyze the long-term results and need for further interventions.
Summary:
- Fifteen patients aged 57-72 underwent subretinal membrane removal, primarily due to age-related macular degeneration.
- Visual acuity pre-operatively ranged from light perception to 1/50.
- Post-operative outcomes were variable, with some patients experiencing improved vision while others faced complications like atrophy or persistent detachment.
Impact:
- Surgical removal of subretinal membranes can lead to improved visual acuity in some patients.
- The procedure carries risks of complications, including retinal pigment epithelium atrophy and recurrent detachment.
- Long-term follow-up is crucial to manage complications and assess the durability of surgical success.