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Surgical Procedures for Macular Degeneration

by Amy Scholten, MPH


At the present time, there are no effective procedures or treatments for the dry form of macular degeneration.


The standard treatment for wet macular degeneration is laser surgery, which stops the blood vessels from leaking and spreading under the macula. However, this procedure can only be performed on a small number of patients with macular degeneration who have well-defined blood vessel development.

Laser Photocoagulation

Laser photocoagulation, used to treat a number of eye conditions, is used in some cases of wet macular degeneration. When blood vessels under the macula multiply in wet macular degeneration, they leak, causing damage and death to the cells of the macula. Photocoagulation involves aiming a strong laser light beam onto the new blood vessels to destroy them. It is not a cure for macular degeneration, but helps prevent further vision loss. Unfortunately, the treatment itself can lead to visual loss.


The procedure is done on an outpatient basis. You will be given eye drops to dilate your pupil and numb your eye. The procedure is performed while you are seated in a chair. You will remain awake and you may feel minimal discomfort as the pulses of laser light are directed at the blood vessels. The treatment usually takes less than thirty minutes to complete and you can go home immediately following surgery. It may take several weeks before you know if the surgery has been successful. You may need additional laser treatments to manage macular degeneration and prevent further vision loss.

Photodynamic Therapy

Photodynamic therapy is a new procedure used to treat wet macular degeneration. It involves using a low-powered laser in conjunction with a light-sensitive dye. The dye will be injected into a vein in your arm and will circulate through your body. As the dye circulates through your eye, it collects in the abnormal blood vessels. Low-intensity laser is aimed at the blood vessels, and the dye absorbs the laser energy and destroys the blood vessels.


The procedure is done on an outpatient basis. You will be given eye drops to dilate your pupil and numb your eye. You will also receive an injection of dye into a vein in your arm. You may feel minimal discomfort as the pulses of laser light are directed at the blood vessels. You may need additional treatments to manage blood vessel growth and prevent further vision loss.


Only about 20% of patients with macular degeneration are candidates for the above therapies. In this group, only approximately half will have an improved outcome. For those who do benefit from the procedure, the gains are often temporary.

Submacular Surgery

Surgical removal of blood and abnormal blood vessels below the macula have been attempted, but has not been very successful. Researchers are currently investigating this and other forms of surgical intervention for macular degeneration.

SOURCES:

Association for Macular Diseases, Inc.


Macular Degeneration Foundation



Last reviewed October 2004 by Marc Ellman, MD


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