Surgery for CNV and autologous choroidal RPE patch transplantation: exposing the submacular space

Abstract

The creation of an FTAP through a 180 degrees peripheral retinotomy is feasible and safe. The FTAP is vital and perfused. Further studies are needed to collect more data.

Assessment of 180° Rotation of the Choroid as a Novel Surgical Treatment for Age-Related Macular Degeneration

“…21,26 In large series of free RPE-choroid grafts harvested from the periphery, most grafts are found to revascularize. [24][25][31][32]45 This revascularization is predominantly horizontal, extending from unprocedured choriocapillaris, and is sufficient to sustain grafts transplanted into areas of chorioretinal atrophy. 46 With spectral domain OCT and angiography, afferent and then efferent vessels can be seen to form between free grafts and neighboring unoperated choroid, resulting in changes in graft thickness, in the days following surgery.…”

“…14,[20][21][22][23][24][25][26][27][28][29][30][31][32] Free RPE-BM-choriocapillaris patch grafts allow larger subfoveal defects to be treated than has proved possible with either translocation surgery or submacular rotation of pedicled grafts. There is, however, an early period of ischemia before revascularization of free grafts, 31,32 which is a possible cause of further compromise to the overlying photoreceptors.…”

25th RCOphth Congress, President's Session paper: 25 years of progress in vitreoretinal surgery

“…This latter problem can been addressed by creating a 180-degree retinectomy and folding the temporal retina over the optic nerve, thereby creating a large area of exposed RPE so that the patch can be created and positioned without trauma to the retina. 60 Once the RPE surgery is complete, the retina is folded back and re-attached using silicone oil. The peripheral RPE patches seem to have good long-term survival, and the visual results are reasonable.…”

Chirurgie der altersbedingten Makuladegeneration – Ist das im Zeitalter der Pharmakotherapie noch eine Option?

“…Retinale Pigmentepithelzellen (RPE) müssen zunächst autolog intraoperativ gewonnen werden und können anschließend direkt oder ggf. nach vorheriger Kultivierung in den sub- [37][38][39][40][41][42][43][44][45][46]. Während die initialen Arbeiten noch ein pedunkuläres Transplantat untersuchten, konnte später gezeigt werden, dass auch ein freies Transplantat einen vaskulären Anschluss an die Aderhaut findet [40][41][42]45] (l " Abb.…”