Macular tranlocation with choriocleral outfolding: an experimental tudy

PURPOE: Macular tranlocation by choriocleral infolding ha been propoed a a urgical intervention for exudative age-related macular degeneration, but the urgery i unpredictable and can be aociated with evere complication. We teted a new urgical technique, macular tranlocation with choriocleral outfolding ecured by neurourgical clip. METHOD: Thi wa a propective interventional tudy in two part; the firt in human cadaver eye and the econd in pig. Choriocleral infolding wa performed on ix human donor eye, and choriocleral outfolding wa performed on an additional ix. The inner urface of the eye wall wa meaured, and then the fold wa unfolded and the ditance wa meaured again. In the econd half of the tudy, macular tranlocation urgery wa performed on 33 pig eye with one of three clera hortening method: 1) a circumferential choriocleral infolding uing 5-0 nylon uture, 2) a circumferential choriocleral outfolding uing cleral clip, or 3) a radial choriocleral outfolding uing cleral clip. Foveal tranlocation wa meaured. REULT: The inner wall of the human cadaver eye wa hortened in the choriocleral infolding group by a mean of 1.6 mm, and in the choriocleral outfolding group by 3.0 mm. In the pig eye, the fovea wa tranlocated a mean 2377 μm by circumferential uturing, 2582 μm by circumferential clipping, and 3386 μm by radial clipping. Irregular deformation of the globe wa more apparent in the circumferential uture group. Undeirable retinal fold often formed after circumferential infolding but not after radial clipping. CONCLUION: Radial choriocleral outfolding with clip i more predictable and effective than infolding. It produce more tranlocation and prevent fold acro the fovea, one of the mot undeirable complication in macular tranlocation urgery.