Surgical Removal of Subfoveal Choroida l Neovascular Membranes in Older Patients.

Kim, Myung Joon; Sohn, Joon hong; Yoon, Young Hee

Original Article

Journal of the Korean Ophthalmological Society 1999;40(12):3390-3399.
Published online December 1, 1999.

Surgical Removal of Subfoveal Choroida l Neovascular Membranes in Older Patients.

Myung Joon Kim, Joon hong Sohn, Young Hee Yoon

Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center.

50 세 이상 환자들의 황반하 맥락막신생혈관막 제거 수술 결과

김명준(Myung Joon Kim),손준홍(Joon Hong Sohn),윤영희(Young Hee Yoon)

Abstract

We report the result of surgical removal of subfoveal choroidal neovascular membranes[CNVM] in patients older than 50 years. Eleven eyes treated consecutively by submacular surgery were included. Etiology of CNVM was age-related macular degeneration in 7 eyes, myopia in 2 eyes, and idiopathic in 2 eyes. All the eyes had vision of 20/200 or worse and had undergone surgeries within 3 months from the onset of visual symptom. After creation of posterior vitreous detachment, neovascular membranes were completely dissected and removed through 36Gsize retinotomies. No laser photocoagulation was placed to the retinotomies, and air bubble of 30% volume of vitreous cavity was left for tamponade at the end of the surgery. Within one month postoperatively, fluorescein angiogram was obtained and confirmed the absence of residual CNVM in all cases. One eye developed a recurrent CNVM 6 months following surgery and was lasered successfully. At the mean follow-up period of 6.4 months, visual acuity was improved in 6 eyes[55%], unchanged in 4 eyes[36%], and worsened in 1 eye[9%] which suffered from diffuse RPE loss during surgery. Although the visual outcome of submacular surgery is expected to be poor in older patients, surgical approach may be beneficial in carefully selected cases with CNVM for improvement or preservation of vision.

Key Words: ARMD;Choroidal neovascular membrane;Older patient;Submacular surgery