Retinal rotation allows patients in many stages of age-related macular degeneration (AMD) to regain almost optimal vision.
At present, there is still no way to completely cure AMD. At best, all treatment methods can stop or slow down the progression of the disease. In this context, retinal rotation has become very important.
During retinal rotation, the affected retina is incised, detached and rotated by around 30 degrees. The aim is to move the macula, i.e. the visual center of the eye, to another part of the pigment cell layer. Ideally, it can then bind to an intact pigment cell again.
If this is successful, the patient can see more clearly again after a short healing and recovery phase. An optimal surgical result can improve vision to an average of 70 percent for five to ten years. A further improvement in vision can be achieved through additional medical treatment and the use of special visual aids.

Retinal rotation can restore better vision in ADM © Henrie | AdobeStock
However, an optimal result cannot be guaranteed with retinal rotation. The success of the treatment depends
- on the condition of the retina and
- the course of the operation
the course of the operation. The actual retinal rotation is also followed by an operation on the eye muscles. Optimal treatment success is only possible if both surgical steps are successful.
In addition to AMD, retinal rotation can also be used for other eye diseases, such as
- other types of growths on the retina or
- Destruction of the center of vision (macula) due to external influences (e.g. accidents or violence)
The first 20 documented retinal rotations were performed in 1997-1998. In order to test the ideal procedure, the surgeons tested different techniques, such as varying degrees of retinal rotation between 20 and 45°.
After the healing phase, vision had improved in more than half of the patients. Almost half of the patients treated were able to read again without any problems after the retinal rotation.
In the meantime, the procedure has become more sophisticated and the success rates have been further increased.
However, statutory health insurance may not cover the entire treatment.
A surgical procedure is always preceded by thorough ophthalmologic examinations. The ophthalmologist identifies the severity of the macular degeneration and, if possible, its cause.
Retinal rotation is not equally suitable for all patients. The doctor must weigh up whether the expected success of the operation is in proportion to the possible risks.
The patient must also be willing to cooperate with the therapy. They must largely eliminate the risk factors that promote the progression of macular degeneration. These include
- Diabetes: Should be optimally controlled.
- High blood pressure: A healthy lifestyle lowers blood pressure.
- Nicotine: Smoking should be stopped completely.
Further therapy after a successful operation is also planned in advance as far as possible. Fine-tuning can only take place after the results of the operation have been evaluated. Nevertheless, you need to know in advance which measures are within your personal and financial means.
Retinal rotation is a rather complex procedure that consists of two surgical stages:
Retinal rotation
First, the doctor removes the crystalline lens and the vitreous body. Only then can he incise and detach the retina. In order to remove new vessels, the optic nerve must be folded back. The surgeon then rotates the retina together with the macula and places it over healthy tissue. The retina is then seamlessly reconnected to the tissue of the eyeball using a laser.
The empty space in the eye left by the removal of the vitreous body is filled with silicone oil or gas so that it cannot collapse. This filler is removed from the eye two to three months after the procedure.
Eye muscle surgery
During a second procedure, the eyeball must be adjusted to the new position of the macula. Without this second treatment step, the patient's vision would be severely distorted after the procedure.
This is also the case if the surgeon does not adjust the new position of the macula correctly.
Retinal rotation is associated with a number of risks:
- Inadequate displacement: the macula may not be able to be displaced far enough from the deformed tissue area for physical or surgical reasons.
- Defense reactions of the body to the silicone oil as a vitreous substitute (relatively rare).
- Retinal tears.
- Deterioration of vision, even days or weeks after successful surgery.
- In some cases, image distortion due to a loss of ability to optimally align both eyes.
- Retinal detachment after the procedure.
Retinal detachment is an ophthalmologic emergency. The patient should see a doctor immediately if they notice any deterioration or change in vision.
The healing phase takes about three months, even if vision is restored much more quickly.
Harmful to the healing process are
- Excessive alcohol consumption,
- unhealthy food,
- Nicotine, especially for the fine vessels of the retina,
- too much time in front of the TV or PC,
- too much physical exertion,
- too bright sunlight.
The eyes must be protected from bright sunlight in the long term. Smoking - which may be resumed later - can also reduce the success of the operation.
Carotenoid lutein, the so-called eye vitamin, helps the retinal blood vessels to heal. It is found in
- yellow and red vegetables (such as peppers and corn),
- peas and
- broccoli
can be found.
You should also make sure you attend all your check-ups with your ophthalmologist.