The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Limited macular translocation for wet age related macular degeneration.

NICE has also issued full guidance on macular translocation with 360° retinotomy for wet age related macular degeneration (NICE interventional procedures guidance 340).

These replace the previous guidance on Macular translocation for age-related macular degeneration (NICE interventional procedures guidance 48, March 2004).  


Age-related macular degeneration is an eye disorder that causes problems with central vision (seeing things straight in front of you) and affects the part of the retina (the back of the eye) called  the macula. Wet macular degeneration happens because fluid leaks into the area under the macula causing scarring.

The aim of macular translocation is to improve vision. It involves cutting and moving the macula on an a nearby healthier area of the retina.

A small cut is made in the retina to get to the outer layers of the eye. A ‘tuck’ is put into these layers with a stitch so that the macula ends up lying over a different part of the choroid layer. This ‘tuck’ method is called limited macular translocation.

Coding and clinical classification codes for this guidance.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)