When Is Surgery the Right Option for Wet AMD?

Anti-VEGF injections are usually the preferred treatment for wet AMD, but there may be some situations where surgery is necessary or recommended as a secondary option. Here are some conditions under which surgery may be considered for wet AMD:

1. Persistent Fluid and Macular Edema: If anti-VEGF injections fail to control the fluid buildup in the macula, surgery may be necessary to remove the fluid and relieve pressure on the retina.

2. Subretinal Neovascularization (SRN): SRN occurs when new blood vessels grow beneath the retina. These vessels can leak fluid and blood, causing significant vision loss. Surgery can involve removing the SRN and the associated scar tissue.

3. Choroidal Neovascularization (CNV): CNV is the abnormal growth of blood vessels from the choroid (a layer of tissue between the retina and the sclera) into the retina. Extensive CNV or recurrent CNV that is unresponsive to anti-VEGF therapy may be treated surgically.

4. Vitrectomy: Vitrectomy is a surgical procedure to remove the vitreous humor (the gel-like substance in the eye's center) and any scar tissue or blood that may be interfering with vision. It may be combined with other surgical procedures to treat wet AMD.

5. Macular Translocation Surgery: This advanced surgical procedure involves moving the central part of the retina (containing the macula) to a healthier area of the retina. It may be considered in select cases of wet AMD where the macula is severely damaged and other treatment options have failed.

6. Retinal Implant Surgery: In rare cases, individuals with advanced wet AMD who have lost significant central vision may be candidates for retinal implant surgery. This involves surgically implanting a device that stimulates the retina to restore some degree of vision.

7. Descemet's Membrane Endothelial Keratoplasty (DMEK): This surgical technique is used to replace the damaged layer of cells on the back of the cornea (the clear outer layer of the eye). It may be considered in certain situations to improve visual acuity in individuals with wet AMD who have additional corneal issues affecting vision.

It's important to note that the decision to pursue surgery for wet AMD is complex and depends on various factors, including the stage and progression of the disease, the individual's overall health, and the potential benefits and risks associated with surgical intervention. Consultation with a qualified ophthalmologist or retinal specialist is essential to determine the most appropriate treatment plan for each individual case of wet AMD.