1Lappas A., 2Foerster A. M. H., 1Weinberger A. W. A., 1Schrage N., 2Kirchhof B.

1Augenklinik der RWTH Aachen, Pauwelsstr. 30, 52057 Aachen, 2Augenklinik der Universität zu Köln

Introduction: Autologous iris pigment epithelial cell translocation is under investigation as a possible therapy of Age Related Macular Degeneration (ARMD). In a pilot study we examined the practicability of autologous IPE translocation and functional outcome in ARMD patients after removal of submacular choroidal neovascularisation (CNV).
Patients and Methods: 56 patients with subfoveal CNV were included in this study. 47 had an occult CNV, nine had a classic CNV that was not amenable for laser photocoagulation according to the criteria of the Macular Photocoagulation Study Group. A vitrectomy and iridectomy were performed and the submacular membrane was removed. Isolated IPE cells were injected into the subretinal space. Examinations included ETDRS visual acuity, SLO microperimetry and fluorescein angiography.
Results: All patients underwent successful surgical removal of CNV with consecutive subretinal IPE injection. Mean preoperative visual acuity both in classic (1,1+/-0,2 logMAR units) and occult CNV (1,0+/-0,3 logMAR units) did not change significantly after one year (classic: 1,1+/-0,3 logMAR units; occult: 1,0+/-0,3 logMAR units). A change of more than two ETDRS chart lines was defined as significant. Ten eyes with preoperative occult CNV developed a recurrence. 44% of all patients demonstrated a fixation within the surgically denuded area.
Conclusions: The surgical procedure could be performed successfully in all patients. Preliminary data suggest, that IPE translocation in submacular surgery for ARMD can preserve, but can not improve preoperative visual acuity over one year. Continued research on improvement of IPE translocation seems justified.

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