97th DOG Annual Meeting 1999
OUTCOME OF SUBMACULAR SURGERY FOR AGE RELATED MACULAR DEGENERATION (AMD) IN 85 CASES
G. Schlunck, N. Feltgen, J. Wiek, P. Janknecht, L. L. Hansen
The surgical treatment of subfoveal macular membranes is currently under discussion. Since subfoveal membrane peeling was the method of choice for recent years, long term data are now available.
Methods: We retrospectively analyzed data on 85 eyes of 83 patients who underwent surgery between march 1996 and march 1998 and were followed up for 13 months (range 43-836 days). Surgery was performed under general anesthesia in 81 of 85 cases. Visual acuity data were transformed to logarithmic data before calculations.
Results: Our patients had a mean age of 74 years. The preoperative visual acuity (VA) ranged from 6/20 to perception of hand motions (mean 6/75). At the last visit the visual acuity had declined by a mean of 2 snellen lines in all patients. 54 eyes (62%) lost visual acuity, 25 of them declined by more than three snellen lines. Unchanged VA was found in 11 eyes (13%) and 22 (25%) eyes improved by a mean of 3 snellen lines (range 1 to 6 lines). Perioperative complications were reported in 24 eyes (28%) including vitreal hemorrhage (17 eyes), retinal tears (4 eyes, 3 of them with primary buckling surgery) or lens extraction (2 eyes). Long term complications occurred in 27 eyes with retinal detachment (11 eyes), cataract (5 eyes), glaucoma (4 eyes), vitreal hemorrhage (6 eyes) and recurrent CNV (7 eyes). When asked, metamorphopsia was described by 78% of our patients before and 13% after surgery.
Conclusions: The surgical removal of subfoveolar membranes results in a decrease of metamorphopsia in a significant number of patients. The increase of visual acuity in 25% indicates an improvement over the natural course of the disease. The recurrence rate is low. This warrants further efforts to determine subgroups of patients that benefit the most from submacular surgery.
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