[Macular hole surgery: experience with autologous platelet concentrate and indocyanine green-assisted internal limiting membrane peeling].
BACKGROUND
To report on our clinical experience with autologous platelet concentrate and indocyanine green(ICG)-assisted internal limiting membrane (ILM) peeling in macular hole surgery.


METHODS
Standard 3-port vitrectomy was performed in 107 eyes of 101 patients (m: f = 27 : 74; mean age 60 +/- 9, range 30 - 80 years) with idiopathic macular hole stages II - IV. After fluid/air exchange, autologous platelet concentrate was applied (1.9 +/- 0,1 x 10(8) thrombocytes). ILM peeling, which was preceded by ICG staining in 19 eyes, was performed in 34 patients.


RESULTS
After one procedure, anatomic success (hole closure) could be achieved in 85 % (n = 68), 75 % (n = 27) and 100 % (n = 3) of the eyes with stage II, III and IV holes, respectively. The mean visual acuity improved by 1 line. The overall initial closure rate of 82 % could be further enhanced to 96 % with a second procedure. In eyes pretreated with ICG, an initial rate of hole closure in 94 % and an improvement of visual acuity by 2 lines was observed.


CONCLUSIONS
Autologous platelet concentrate appears to be a safe and reliable adjunct to improve the anatomical outcome of conventional macular hole surgery. Functional results can be further enhanced by ICG-assisted ILM peeling
Kube
Thomas
T
Augenklinik der Albert-Ludwigs-Universität Freiburg, Freiburg. kube@aug.ukl.uni-freiburg.de
Hermel
Martin
M
Dahlke
Claudia
C
Hutschenreuter
Gabriele
G
Schrage
Norbert
N
Kirchhof
Bernd
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets; D001804:Blood Transfusion, Autologous; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D017713:Platelet Transfusion; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*
D009883:Ophthalmic Solutions; D007208:Indocyanine Green