New techniques for vitreoretinal surgery enable the removal of submacular neovascular membranes inaccessible to laser coagulation. The present study describes the anatomical and functional results following membrane removal.
Patients: Between January 1994 and June 1995, submacular neovascular membranes were removed from 56 eyes with age-related exudative macular degeneration. Thirty-one eyes had classic subfoveal membranes; 19, occult membranes; and 6 eyes, disciform fibrotic changes that had already persisted for more than 6 months.
Results: Surgery led to improved vision in 20 of the 56 eyes (36%). In 26 of the 56 eyes (44%) vision at the last follow-up was no different from preoperative vision: in 10 eyes (17%) visual acuity declined. In the group of 6 eyes with a 6-month history of exudative maculopathy, surgery produced a slight improvement in vision in most patient. Complications arose in 8 of the 56 eyes (14%), namely choroidal hemorrhage (2 eyes), a macular hole (1 eye), and peripheral retinal detachment (5 eyes). Recurrence of the membrane was seen in 5 eyes (9%).
Conclusion: Surgical removal of submacular membranes can often lead to stabilization or even improvement of vision. Owing to the relatively high rate of complications, however, the indications must be rigorously appraised on a case-by-case basis.