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M Turati, H Quiroz-Mercado, JL Guerrero-Naranjo, I Yeshurun, G Garcia-Aguirre, L Morfin, F Koch; Viscoelastic Foveal Detachment and Endoscopic Subretinal Laser Photocoagulation of Subfoveal Choroidal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2526.
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Purpose: To demonstrate the ability to use endoscopic laser photocoagulation of subfoveal choroidal neovascularization (CNV) with 532 nm laser following viscoelastic-induced foveal detachment. Method: Patients with subfoveal CNV underwent surgery with subretinal laser photocoagulation. The surgical procedure performed was as follows: pars plana three-port vitrectomy, posterior hyaloid removal, subretinal injection of sodium hyaluronate (SH) through a small retinotomy to separate the retina from the CNV-RPE complex, creation of a dome shaped retinal detachment with the SH bubble, endoscopic laser photocoagulation, SH aspiration, air-fluid exchange, SF6 as tamponade, and face down positioning. Preoperative and postoperative visual acuity (ETDRS chart) and fluorescein angiography (FA) were evaluated, as well as the presence of complications. Results: Eight eyes of eight patients were treated in this study. Five eyes (62.5%) had improved visual acuity by three lines or better, two eyes (25%) remained unchanged and one eye (12.5%) had diminishment of visual acuity. Complications included one vitreous hemorrhage with total retinal detachment, one partial retinal detachment and one patient with secondary glaucoma. In all cases preoperative FA showed late hyperfluorescence consistent with CNV. In seven of eight cases postoperative FA showed partial resolution of the CNV, as well as hyperfluorescent areas, which could be suggestive of proliferating RPE. Conclusion: Viscoelastic foveal detachment and endoscopic subretinal laser photocoagulation of subfoveal CNV is a feasible and novel surgical procedure which warrants further study and evaluation.
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