Macular degeneration surgery is being performed in select patients who have wet macular degeneration in Italy. The surgery is an autologous choroidal transplant - meaning the procedure uses the patient's own tissue so there is less chance of rejection.
“We cannot transplant the retina but we can replace the damaged layer under the retina with a healthy patch of choroid, providing a healthier substrate to nourish the retina,” stated Gracia Fertile, MD, head of Ophthalmology Department of Negrar Hospital, Italy. She is one of the few surgeons in Europe who performs this procedure.
The choroid is a layer of blood vessels and capillaries in the retina and is the only source of blood to the macula. It brings nutrients to the macula and nourishes the back of the eye including the rods and cones and the retinal pigemnt epithelium (RPE).
Not everyone who has wet macular degeneration is a candidate for this surgery. Patients must meet certain criteria before being considered. Here are some of them:
1. Have wet macular degeneration often with complications like large sub retinal bleeding or retinal pigment epithelium tears.
2. Not responding to anti-VEGF injections
3. Have healthy patches of choroid/photoreceptor layers as determined by Optical Coherence Tomography (OCT).
4. Relatively healthy and can tolerate a 1.5 -2 hour surgery under general anesthesia
"Cases of large sub retinal hemorrahge and RPE rupture involving the fovea or patients who do not respond to anti-VEGF with any of the available drugs (may benefit)" Grazia Pertile, MD, said at the Bassano Ophthalmology meeting.
“We may be able to rescue a retina that needs reanimation but cannot resuscitate a dead retina,” Pertile said.
The procedure involves several steps and is a 1.5-2 hour surgery. Here is a link to the video of how the surgery is done. Not sure why they chose the Pink Panther to "moderate" but it still is a very informative video:
According to Pertile, “The choroidal patch should be harvested from an area far enough from the area of transplantation to avoid fibrotic reactions.”
Dr. Pertile has been performing choroidal transplants since 2006 on 120 patients. The results have been different with each patient, but some patient were able to regain 20/20 vision. In less than 10% of the cases serious complications developed.
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