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Surgery for Macular Degeneration

Macular degeneration is an eye condition that is the main cause of vision loss in older adults, particularly those over the age of 50.1 The condition is not curable and tends to progress over time. There are treatments for macular degeneration, which can help to slow the progression of the disease, preserve your existing vision, and reduce the risk of more severe vision loss. Depending on the kind of macular degeneration you have, treatment options can vary.

Surgical options

In addition to assistive devices and medications, surgery is a potential treatment modality for patients with AMD and myopic macular degeneration. Laser surgery is an option for certain people with wet AMD, but there are also more involved surgical options that retinal specialists may consider for patients with severe disease; these operations may include submacular surgery and retinal translocation. Different people respond differently to various kinds of treatment, and invasive surgery is generally reserved as a last resort when medical and/or laser treatments have failed, so talk with your doctor about what treatment options might be right for you.

Submacular surgery

Submacular surgery involves the removal of lesions of abnormal blood vessels, scar tissue, and any abnormal bleeding from under the retina. It was thought that the removal of these lesions might help slow down or stop visual impairment in certain patients with wet AMD and myopic macular degeneration. However, studies funded by the National Eye Institute called the Submacular Surgery Trials (SST), found that patients who underwent submacular surgery did not actually achieve stability or improvement in vision after undergoing the operation.2 However, surgical techniques can vary widely among surgeons, and each person may respond differently to surgery. If your AMD doesn’t respond to other treatments, your doctor may suggest submacular surgery as an option.

Retinal translocation

Retinal translocation is a surgical procedure that detaches a segment of the retina (which may include the macula) from an unhealthy part of the eye and places it in a healthier part of the eye. It is only a treatment option for wet AMD and works best in the earlier stages of the disease when the retina has not been significantly damaged.3 Surgical results can vary, with some patients experiencing improvement in their vision and others remaining the same or even worsening. Long-term effects in those who have had the surgery have been positive for some, with visual function being maintained for longer periods of time post-operatively.4 Overall, however, there are mixed results regarding whether this surgery can significantly improve vision for those with wet AMD, especially when there are various other treatment options available.5

Exhausting all other treatment options

Surgery for macular degeneration is often considered if other treatment options have been exhausted, and nothing has helped. In cases of myopic macular degeneration, you might want to talk with your doctor about non-surgical treatments first.6 If your macular degeneration isn’t responding to other treatments, talk with your doctor about whether surgery is appropriate for you and your type of macular degeneration. Surgery isn’t something to decide on lightly, and it’s worth discussing with your doctor and gathering all of the possible information in order to make an informed decision that aligns with your expectations and lifestyle.

Written by Jaime R. Herndon | Reviewed September 2019
  1. National Institutes of Health: National Eye Institute. Facts About Age-Related Macular Degeneration. 2015. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed December 27, 2018
  2. National Institutes of Health: National Eye Institute. Vision Not Improved By Surgery for Complications of Age-Related Macular Degeneration. 2004. https://nei.nih.gov/news/statements/surgery_amd. Accessed December 28, 2018.
  3. Prevent Blindness. Macular Translocation. 2003. https://lowvision.preventblindness.org/2003/11/25/macular-translocation. Accessed December 28, 2018.
  4. Oshima H, Iwase T, Ishikawa K, Yamamoto K, Terasaki H. Long-term results after limited macular translocation surgery for age-related macular degeneration. PLoS One. 2017; 12(5). Doi: 10.1371/journal.pone.0177241. Accessed December 28, 2018.
  5. Eandi CM, Giansanti F, Virgili G. Macular translocation for age-related macular degeneration. Cochrane. 2008. https://www.cochrane.org/CD006928/EYES_macular-translocation-for-age-related-macular-degeneration. Accessed December 28, 2018.
  6. Raecker ME, Park D-W, Lauer AK. Diagnosis and Treatment of CNV in Myopic Macular Degeneration. American Academy of Ophthalmology. 2015. https://www.aao.org/eyenet/article/diagnosis-treatment-of-cnv-in-myopic-macular-degen. Accessed January 29, 2019.