Effect of indocyanine green staining in peeling of internal limiting membrane for retinal detachment resulting from macular hole in myopic eyes.
OBJECTIVE
To investigate the effect of using indocyanine green (ICG) to stain the internal limiting membrane (ILM) during vitrectomy in eyes with retinal detachment resulting from macular hole (MHRD).


METHODS
Nonrandomized comparative trial.


METHODS
Thirty-two cases of MHRD.


METHODS
The medical records of the cases were reviewed retrospectively. During the initial vitrectomy, the ILM was peeled in 22 eyes with ICG (group A) and in 10 eyes without ICG (group B).


METHODS
Anatomic reattachment, visual acuity, and optical coherence tomography-determined macular hole closure were measured.


RESULTS
The initial reattachment rate in group A (86%) was significantly higher than in group B (40%; P = 0.013, Fisher exact test). The postoperative visual acuity at 6 months and the visual improvements at 6 and 12 months in eyes with an initial reattachment were not significantly different between the 2 groups (P = 0.123, Mann-Whitney rank-sum test; P = 0.17, t test; P = 0.237, t test). The postoperative visual acuity at 12 months with an initial reattachment in group A was significantly better than in group B (P = 0.039, t test). The macular hole closure rate with an initial reattachment was 6 of 17 eyes (35%) in group A and 0 of 4 eyes (0%) in group B, and this difference was not significant (P = 0.281, Fisher exact test).


CONCLUSIONS
These results show that ICG staining improves the initial reattachment rate and is associated with better postoperative visual acuity at 12 months. Therefore, ICG staining should be used during vitrectomy for MHRD because the complete removal of the ILM with ICG ensures the removal of the tangential traction by an epiretinal membrane and the inverse traction by the retina that cannot follow the posterior enlargement of a staphyloma.
Oie
Yoshinori
Y
Department of Ophthalmology, Osaka Rosai Hospital, Osaka, Japan. yoie@orh.go.jp
Emi
Kazuyuki
K
Takaoka
Gen
G
Ikeda
Toshihide
T
D000368:Aged; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D009216:Myopia / Q000150:complications*; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013194:Staining and Labeling / Q000379:methods; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D005466:Fluorocarbons; C042852:perflutren; D007208:Indocyanine Green; D013459:Sulfur Hexafluoride