Limited macular translocation

The mascular translocation procedure is a promising treatment modality as it offers patients a chance of potentially improving their vision to an acceptable level for reading and driving. Functionally, those patients with subfoveal CNV of recent onset without permanent foveal sensory retina damage have the greatest likelihood of successful macular translocation. Anatomically, the best candidates have a small minimum desired translocation, with healthy RPE/Bruch's membrane/choriocapillaris outside the lesion. The aetiology is usually AMD, but pathological myopia, ocular histoplasmosis syndrome, angioid streaks, idiopathic and multifocal choroiditis-related CNV might be considered. A variety of ocular complications can occur during or following LMT and some are associated with reduced post-operative visual acuity. Improved surgical techniques and experience may significantly reduce the incidence of these complications. The most important complication is retinal detachment, which can usually be repaired, although it may affect the final visual result. The exact role of translocation is not yet established and a pilot multicentre randomised clinical trial is under way to compare the results of LMT with either photodynamic therapy or observation in eyes with subfoveal CNV secondary to AMD.