Macular Translocation Using 360 Degrees Circumferential Scleral Shortening

Abstract

Abstract: : Purpose: To describe a new technique for macular translocation, intended to combine the relative safety of limited macular translocation with the effectiveness of extended macular translocation. Methods: Following phacoemulsification, intraocular lens implantation, vitrectomy and retinal detachment, the sclera is shortened all around using pre placed interrupted radial mattress sutures. The redundancy of the retina thereby created enables the rotation of the entire retina around the optic nerve, without the need for peripheral retinectomy. Results: Three eyes of three patients were operated. In all cases the fovea was shifted to a distance of approximately 2000 microns (2150, 2100 and 2000 microns). In one eye visual acuity significantly improved (counting fingers [CF] from 1 meter to 6/45(-1)). In another eye visual acuity did not change significantly (CF from 4 meters to CF from 3 meters). Visual function was lost in the third eye due to acute postoperative endophthalmitis. Anterior segment ischemia did not develop despite the extensive scleral shortening. Conclusions: Retinal rotation using all around scleral shortening is a new translocation technique with a potential to provide relatively large, predicted and controlled foveal shift. Not having to perform circumferential retinectomy makes it theoretically safer than the conventional extended macular translocation technique.

Keywords: aging • age-related macular degeneration • retina