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Clinical findings in macular hole surgery with indocyanine green-assisted peeling of the internal limiting membrane

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Abstract

Purpose

Indocyanine green (ICG) staining of the internal limiting membrane has facilitated ILM peeling in macular hole surgery. However, it has been reported that ICG-assisted peeling of the ILM may result in retinal damage and unfavorable functional outcome. Therefore, we analyzed our visual and anatomical results of ICG assisted macular hole surgery.

Methods

In a retrospective study the records of a consecutive series of 37 patients with full-thickness idiopathic macular holes operated with ICG-assisted ILM peeling by a single surgeon were analyzed. All patients underwent a standard three-port vitrectomy with surgically induced posterior vitreous detachment, staining of the ILM with ICG, peeling of the ILM in a circular manner around the fovea, and SF6 20% endotamponade.

Results

A total of 37 patients (37 eyes) were included in the study. The mean age was 69±7 years (range 52–81 years), and there were 26 women and 11 men. The follow-up ranged from 6 to 30 months (mean 18±6 months). At baseline visual acuity ranged from 20/400 to 20/40. Anatomically, 13 eyes had stage 2 holes, 21 eyes (57%) stage 3 holes, and three eyes stage 4 holes. At the postoperative visit (8–12 weeks after surgery) anatomical closure of the macular hole was achieved in 36 eyes. Visual acuity ranged between 20/400 and 20/20. At the last follow-up after initial surgery the macular hole was closed in all eyes. Visual acuity ranged from 20/200 to 20/20.

Conclusion

In our retrospective series anatomical and functional results of macular hole surgery with ICG-assisted peeling of the ILM are satisfactory. Primary hole closure was achieved in 97% of eyes and visual acuity increased in 62% of eyes in our series.

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Correspondence to S. Wolf.

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Proprietary interest: none

Presented in part at the annual meeting of the Deutsche Ophthalmologische Gesellschaft (DOG), Berlin, 2002

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Wolf, S., Reichel, M.B., Wiedemann, P. et al. Clinical findings in macular hole surgery with indocyanine green-assisted peeling of the internal limiting membrane. Graefe's Arch Clin Exp Ophthalmol 241, 589–592 (2003). https://doi.org/10.1007/s00417-003-0673-1

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  • DOI: https://doi.org/10.1007/s00417-003-0673-1

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