Long-term outcomes following full macular translocation surgery in neovascular age-related macular degeneration
Résumé
Background/aims: Long-term data of macular translocation for choroidal neovascularisation (CNV) secondary to age-related macular degeneration is lacking. Therefore, we describe the 3-year acuity outcomes. Methods: This is a retrospective, interventional case series consisting of 40 consecutive patients who underwent translocation between 2003 and 2008. Best-corrected visual acuity (BCVA) at the most recent follow-up visit was compared to that of the 1 year and pre-operative visits. Delayed post-operative complications were recorded, as diagnosed by clinical examination, spectral-domain optical coherence tomography, fundus autofluorescence imaging and angiography. Results: The mean (range) follow-up duration was 37.6 (12.4-67.4) months. Median BCVA were 0.80, 0.70 and 0.78 logMAR at the baseline, 1 year and most recent visits (p = 0.13). A 3-line gain in BCVA was seen in 12 (30%) patients at 1 year and 10 (25%) patients at the last observation. Twenty-seven (68%) patients achieved a BCVA of 6/60 or better and 6 (15%) patients, 6/12 or better at the final visit. In the subset of the cohort followed for 2 or more years, 24 of 32 patients (75%) achieved a BCVA of 6/60 at 1 year but 6 of these (25%) lost 2-lines of BCVA thereafter due to recurrent CNV, idiopathic macular oedema, macular hole or macular pucker. Recurrent CNV developed in 9 patients (23%) within the first 2 years and their final mean VA was 6/30. Conclusions: With close post-operative monitoring and early treatment of delayed complications, 25% of this cohort maintained a 3-line gain in acuity at 3 years after macular translocation.
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