Surgical excision versus laser photocoagulation for subfoveal choroidal neovascular membrane with age-related macular degeneration: comparison of visual outcomes.

PURPOSE This study was designed to compare visual acuity after laser photocoagulation with visual acuity after surgical excision of the subfoveal choroidal neovascular membrane in patients with age-related macular degeneration (AMD). METHODS We studied 54 patients (56 eyes) who underwent laser photocoagulation and 52 patients (52 eyes) who underwent surgical excision for new subfoveal choroidal neovascular membrane occurring with AMD. We compared mean log of minimal angle of resolution (MAR) visual acuity, and the percentages of eyes showing visual improvement and a visual acuity of 0.1 or better, between the two treatment groups at 12 months after treatment. The groups were also compared according to choroidal neovascular membrane size, ie, 1 disc diameter (DD) or smaller vs larger than 1 DD. RESULTS Mean corrected visual acuity (P <.01), percentage of eyes with improved vision (P <.01), and percentage with a visual acuity of at least 0.1 (P <.01) were higher in surgically treated eyes. The differences in mean log MAR visual acuity and the percentages were significant only for choroidal neovascular membrane of one DD or less in size. CONCLUSIONS Postoperative eyes, especially those with choroidal neovascular membranes 1 DD or less in size, had better visual outcomes. Patients who meet our eligibility criteria, especially with small choroidal neovascular membranes 1 DD or less in size, should undergo surgical excision.