A Free Retinal Pigment Epithelium-Choroid Graft in Patients With Exudative Age-Related Macular Degeneration: Results up to 7 Years

Elsbeth Zeeburg, Kristel Maaijwee, TOAR Missotten, H Heimann, Johan van Meurs

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Abstract

PURPOSE: To report and analyze long-term best-corrected visual acuity (BCVA) outcomes following a free autologous retinal pigment epithelium (RPE)-choroid graft translocation in patients with exudative age-related macular degeneration (AMD). DESIGN: Prospective cohort study. METHODS: SETTING: Institutional. STUDY POPULATION: One hundred and thirty consecutive patients (133 eyes) with AMD underwent RPE-choroid graft translocation between October 2001 and February 2006. All patients had a subfoveal choroidal neovascular membrane with or without hemorrhage and/or an RPE tear. All were either ineligible for or nonresponsive to photodynamic therapy, the standard treatment at the time of surgery. OBSERVATION PROCEDURES: Data collection included preoperative and postoperat RESULTS: The mean preoperative BCVA was 20/250. Four years after surgery, 15% of the eyes had a BCVA of >20/200, and 5% had a BCVA of >= 20/40. One patient achieved a BCVA of 20/32, which was maintained at 7 years after surgery. Complications consisted of proliferative vitreoretinopathy (n = 13), recurrent neovascularization (n = 13), and hypotony (n = 2). CONCLUSIONS: RPE-choroid graft transplantation may maintain macular function for up to 7 years after surgery, with relatively low complication and recurrence rates. Retinal sensitivity, BCVA data, and fixation on the graft suggest that the graft, rather than simply the removal of submacular hemorrhage and/or choroidal neovascular membrane, was responsible for the preservation of macular function. This surgery may be an alternative for patients with AMD who cannot undergo other standard treatment
Original languageUndefined/Unknown
Pages (from-to)120-127
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume153
Issue number1
DOIs
Publication statusPublished - 2012

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