Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?
OBJECTIVE
To evaluate functional and anatomical outcome of triamcinolone acetonide assisted internal limiting membrane (ILM) peeling in patients with macular hole.


METHODS
Fifteen eyes of 15 consecutive patients were identified with stage 3 and 4 idiopathic macular holes, these undergoing triamcinolone acetonide assisted ILM peeling for macular holes. These were matched retrospectively with 15 eyes of 15 patients with stage 3 and 4 idiopathic macular holes of less than six months duration, who underwent macular hole surgery with ILM peel augmented with indocyanine green (ICG). Functional and anatomical outcomes were compared between two groups.


RESULTS
There were no significant differences between the two groups with reference to demographic features of age, sex, staging of the macular holes and the proportion subsequently undergoing cataract surgery. The mean follow-up period was 6.4 months in the triamcinolone acetonide group and 7.2 months in the ICG group. The hole closure rate was 100% in both group at primary operation. The mean Snellen line change was +1.24 in the intravitreal triamcinolone group and +1.1 in the ICG group. There was a significant improvement in Snellen and Logmar visual acuity in both groups. These differences in visual outcome between the groups were not statistically significant.


CONCLUSIONS
Our data showed similar outcomes for patients with macular hole where ICG has been used when compared to patients where triamcinolone acetonide has been used for ILM peeling. Further study with longer follow-up and large series is warranted to assess the safety of the triamcinolone acetonide assisted ILM peeling in macular hole surgery.
Karacorlu
Murat
M
Istanbul Retina Institute, Inc., Hakki Yeten Cad. No:8/7, Sisli, 34349 Istanbul, Turkey. retina@pobox.com
Ozdemir
Hakan
H
Arf Karacorlu
Serra
S
D001485:Basement Membrane / Q000473:pathology / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green
Am J Ophthalmol. 2002 Nov;134(5):661-6
12429240
Arch Ophthalmol. 1997 Jan;115(1):11-21
9006420
Ophthalmology. 1994 Mar;101(3):534-41
7510380
Ophthalmology. 1999 Jul;106(7):1392-7; discussion 1397-8
10406628
Am J Ophthalmol. 2001 Mar;131(3):387-8
11239880
Am J Ophthalmol. 2002 Jan;133(1):89-94
11755843
Ophthalmology. 2003 Mar;110(3):604-8
12623830
Am J Ophthalmol. 2004 Jan;137(1):172-3
14700661
Arch Ophthalmol. 2000 Aug;118(8):1116-8
10922208
Retina. 2003 Dec;23(6):883-4
14707850
Invest Ophthalmol Vis Sci. 2003 Jan;44(1):370-7
12506098
Ophthalmology. 2001 Aug;108(8):1471-6; discussion 1477-8
11470703
Ophthalmology. 2000 Oct;107(10):1939-48; discussion 1948-9
11013203
Arch Ophthalmol. 2002 Jan;120(1):29-35
11786054
Retina. 2000;20(5):554-5
11039438
Am J Ophthalmol. 2001 Sep;132(3):433-5
11530072
Graefes Arch Clin Exp Ophthalmol. 2001 Jun;239(5):388-90
11482344