title: Retrospective analysis of vitrectomy with and without internal limiting membrane peeling for stage 3 and 4 macular hole.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of pars plana vitrectomy with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling versus pars plana vitrectomy without ILM peeling for stage 3 and 4 primary idiopathic macular hole.
  
  
  METHODS
  Sixty-two eyes of 60 consecutive patients with idiopathic macular hole underwent vitrectomy with gas (C3F8) injection. The first 46 eyes underwent vitrectomy without ILM peeling; of these, 14 had epiretinal membrane peeling and were excluded, leaving 32 eyes (no ILM group). The remaining 16 eyes underwent vitrectomy with ICG-assisted ILM peeling (ICG-ILM group). Follow-up data at 6 to 48 months postoperatively were recorded and analyzed.
  
  
  RESULTS
  Macular hole closure was achieved in 13 (81%) of 16 patients in the ICG-ILM group and 16 (50%) of 32 patients in the no ILM group (P = .036). Analysis of the data from eyes with closed holes indicates that the ICG-ILM group achieved a better mean final visual acuity compared with the no ILM group (20/60 vs 20/100, respectively) (P = .017). No complications were attributed to the use of ICG.
  
  
  CONCLUSIONS
  ICG-assisted ILM peeling significantly increased the rate of hole closure in eyes with stage 3 or 4 idiopathic macular hole. The use of ICG did not adversely affect the visual acuity results, and it appears to be a safe adjunct to macular hole surgery.
authors.affiliation: The Goldshleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Ben Simon
authors.forename: Howard
authors.initials: H
authors.lastname: Desatnik
authors.forename: Amir
authors.initials: A
authors.lastname: Alhalel
authors.forename: Giora
authors.initials: G
authors.lastname: Treister
authors.forename: Joseph
authors.initials: J
authors.lastname: Moisseiev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D004396:Coloring Agents; D005466:Fluorocarbons; C073608:perfluorooctane; D007208:Indocyanine Green