Objective: To assess the prevalence of recurrence of macular geographic atroph y (GA) of the retinal pigment epithelium (RPE) after macular translocation with 360°retinectomy (MT360) in one institution. Methods: A retrospective review of all cases of GA that were treated with MT360 in 1 institution. Demographic and c linical data including the duration of preoperative visual loss, preoperative an d postoperative visual acuity, and the prevalence of postoperative foveal RPE at rophy were recorded for these patients, and these data were compared with simila r data from patients who underwent MT360 for neovascular age-related macular degeneration (AMD) as part of the prospective Duke Macula r Translocation Study, Duke University Eye Center, Durham, NC. Results: Four eye s in 4 patients with GA secondary to AMD underwent MT360 and were compared with 63 eyes in 63 patients who underwent MT360 for neovascular AMD as part of the Du ke Macular Translocation Study. The mean duration of preoperative visual loss wa s higher in the GA group (11.3 months) than in the neovascular AMD group (1.7 mo nths) (P=.08). The prevalence of postoperative foveal RPE atrophy was significan tly higher in theGAgroup (n=3; 75.0%) than in the neovascularAMDgroup (n=5; 8.3 %) (P< .01); in the GA group, this corresponded to recurrence of the GA lesions . In contrast, the postoperative RPE atrophy seen in the neovascularAMD group wa s due to postoperative mechanical forces such as laser therapy or RPE tearing. T here was no significant difference in the mean preoperative or postoperative vis ual acuity in either group. Conclusions: Subfoveal RPE atrophy can reoccur follo wing MT360 in eyes with nonneovascularAMDandGA; RPE atrophy similar to this has not been found in a large consecutive series of patients with neovascular AMD af ter MT360. Further research is needed to assess if the potential for visual reco very in eyes with endstage nonneovascular AMD is outweighed by the possibility o f postoperative recurrence of GA. Objective: To assess the prevalence of recurrence of macular geographic atroph y (GA) of the retinal pigment epithelium (RPE) after macular translocation with 360 ° retinectomy (MT360) in one institution. Methods: A retrospective review of all cases of GA that were treated with MT360 in 1 institution. Demographic and cinical data including the duration of preoperative visual loss, preoperative an d postoperative visual acuity, and the prevalence of postoperative foveal RPE at rophy were recorded for these patients, and these data were compared with simila r data from patients who underwent MT360 for neovascular age-related macular degeneration (AMD) as part of the prospective Duke Macula r Translocation Study, Duke University Eye Center, Durham, NC. Results: Four eye s in 4 patients with GA secondary to AMD underwent MT360 and were compared with 63 eyes in 63 patients who underwent MT360 for neovascular AMD as part of the Duke Macular Translocation Study. The mean duration of preoper ative visual loss wa s higher in the GA group (11.3 months) than in the neovascular AMD group (1.7 mo nths) (P = .08). The prevalence of postoperative foveal RPE atrophy was significantly higher in the GAgroup (n = 3; 75.0%) than in the neovascular AMD group (n = 5; 8.3%) (P <.01); in the GA group, this corresponded to recurrence of the GA lesions. In contrast, the postoperative RPE atrophy seen in the neovascular AMD group was due to postoperative mechanical forces such as laser therapy or RPE tearing. T here was no significant difference in the mean preoperative or postoperative visual acuity in either group. Conclusions: Subfoveal RPE atrophy can reoccur follo wing MT360 in eyes with nonneovascular AMDDgaGA; RPE atrophy similar to this has not been found in a large consecutive series of patients with neovascular AMD af ter MT360. Further research is needed to assess if the potential for visual reco very in eyes with endstage nonneovascular AMD is outweighed by the possibility of postoper ative recurrence of GA.