Long-term outcomes of internal limiting membrane peeling with and without indocyanine green in macular hole surgery.
OBJECTIVE
To compare the long-term anatomic closure rate and visual outcome in patients who underwent internal limiting membrane (ILM) peeling with and without indocyanine green (ICG) dye staining for idiopathic macular hole repair.


METHODS
Retrospective, nonrandomized, comparative study of consecutive case series.


METHODS
A total of 190 eyes of 182 patients with idiopathic macular holes underwent macular hole repair between March 1998 and June 2003. Surgery consisted of pars plana vitrectomy, lensectomy if phakic, ILM peeling, intravitreal gas tamponade, and 1 week's face-down positioning. In the initial 94 consecutive eyes, ILM peeling was performed without adjuvants (non-ICG group). The subsequent 96 eyes underwent surgery with ICG-stained ILM peeling (ICG group), in which the ILM was stained with intravitreal application of 0.1 to 0.2 mL of 0.1% ICG solution.


RESULTS
Two groups of patients had comparable clinical backgrounds preoperatively. Mean follow-up time was 30.7 months in non-ICG group and 26.2 months in ICG group. Anatomic closure of the macular hole was achieved in 99% of the cases in both groups, with both groups showing statistically significant visual improvement. There was no statistically significant difference in visual acuity between the two groups at each follow-up visit. There were also no intraoperative or postoperative complications attributed to the use of ICG.


CONCLUSIONS
Long-term follow-up of patients undergoing ILM peeling for idiopathic macular hole repair shows equivalent anatomic and visual outcomes with and without the use of ICG.
Kumagai
Kazuyuki
K
Shinjo Ophthalmologic Institute, Miyazaki, Japan. kumagai3@f8.dion.ne.jp
Furukawa
Mariko
M
Ogino
Nobuchika
N
Uemura
Akinori
A
Larson
Eric
E
D000368:Aged; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008297:Male; D016684:Prone Position; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013194:Staining and Labeling / Q000379:methods; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D016896:Treatment Outcome; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green; D013459:Sulfur Hexafluoride