Microsurgery of the macula lutea]

Modern surgery of the macula exists since 1965, and was initially proposed in membrane removal from patients presenting an idiopathic epiretinal membrane. This first indication authorized the development of macular microsurgical instrumentation and further analysis of membrane fragments. However, the exact pathogenesis of these membranes remains yet unknown. Since 1991 macular surgery was applied in the treatment of macular holes. Results obtained after macular hole surgery confirmed pathogenic hypothesis observed clinically by Gas. Considerable improvement was therefore achieved in anatomical and functional outcome. Chorioretinal adhesion agents were recently proposed to optimize the closure of macular holes. Submacular surgery is the latest technologic achievement under investigation. The ultimate indications are age-related macular degeneration, first cause of blindness in industrialized countries. Retinal transplantation opens new avenues in the treatment of a large number of chorioretinal diseases. The assessment of macular surgery could pave the way in realising such technical advances.