97th DOG Annual Meeting 1999



A. Lappas1, A. W. A.Weinberger1, S. Wolf2, A. M. H.Foerster1, B. Kirchhof1

Introduction: The removement of the submacular choroidal neovascular tissue is a possible surgical therapy for the exsudative form of Age Related Macular Degeneration (ARMD). To cover the postoperative defect in the layer of the retinal pigment epithelial cells the subretinal injection of autologous iris pigment epithelial cells (IPE-cells) was performed.

Methods: Ten patients with exsudative ARMD were included in this study. Five patients had subfoveal choroidal neovascular membranes (two with occult CNV, three with classic CNV), five had a pigment epithelial detachment (PED). First an iridectomy with IPE-cell preparation was performed. After the extraction of the membrane the IPE-cell suspension was injected into the subretinal space. The patients were followed up for 6 months. The results of the visual acuities, retinal photographs and fluorescein angiograms were evaluated.

Results: Nine of the ten patients underwent a sucessful surgical extraction of the CNV prior to the IPE cell injection. When compared to the preoperative visual acuities (0,05-0,3) no significant change could be observed after 6 months (0,067-0,3). A change of two lines in the visual acuity charts was defined as significant. In one case a recurrence led to a drop of visual acuity. Postoperative fluorescence angiographic findings revealed a hyperfluorescence in the macular area in eight patients. Two of the patients with preoperative PED showed a leakage at the margins of the surgical defect, in one patient a recurrence developed.

Conclusions: The removal of the submacular tissue was successful in most of the cases, in one case, however, a recurrence occured. After 6 months visual acuity reached the preoperative values. The injection of iris pigment epithelial cells caused no additional complication. Further clinical investigations are needed to examine the long term results after this surgical procedure.

Department of Ophthalmology, University of Aachen, Pauwelsstr. 30, 52057 Aachen
Department of Ophthalmology, University of Leipzig, Liebigstr 10-14, 04103 Leipzig