Macular hole surgery with triamcinolone acetonide-assisted internal limiting membrane peeling: one-year results.
OBJECTIVE
To report the 1-year results of macular hole surgery with triamcinolone acetonide (TA)-assisted internal limiting membrane (ILM) peeling and to compare those with results of indocyanine green (ICG)-assisted ILM peeling.


METHODS
In a nonrandomized, retrospective, interventional case series, 40 eyes of 39 consecutive patients with idiopathic full-thickness macular holes underwent macular hole surgery with TA-assisted ILM peeling. Surgical results 1 year after surgery, including changes in best-corrected visual acuity (BCVA) and macular hole closure, were evaluated. Moreover, we compared the results for these 40 eyes (TA group) with those for 27 eyes of 27 consecutive patients who had undergone macular hole surgery with 0.25% ICG-assisted ILM peeling (ICG group).


RESULTS
In the TA group, macular holes were closed in 39 (98%) of 40 eyes. Mean BCVA +/- SD significantly improved from 0.78 +/- 0.31 logarithm of the minimal angle of resolution (logMAR) preoperatively to 0.20 +/- 0.30 logMAR (P < 0.001). BCVA improved by > or =0.2 logMAR in 37 eyes (93%). BCVA was 20/40 or better in 33 (83%) of 30 eyes. In the ICG group, macular holes were closed in all 27 eyes (100%), and mean BCVA +/- SD significantly improved from 0.81 +/- 0.4 logMAR preoperatively to 0.34 +/- 0.2 logMAR 1 year postoperatively (P < 0.001). BCVA improved by > or =0.2 logMAR in 22 eyes (81%). BCVA was 20/40 or better in 16 (59%) of 27 eyes. Significant differences between groups were seen in mean BCVA 1 year after surgery (P = 0.049) but not in BCVA of 20/40 or better (P = 0.17) or change in BCVA by > or =0.2 logMAR (P = 0.05).


CONCLUSIONS
TA is useful as an adjuvant for ILM peeling in macular hole surgery, and BCVA 1 year after surgery might be more favorable when compared with ICG-assisted ILM peeling.
Nomoto
Hiroyuki
H
Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan. nomoto@med.kagawa-u.ac.jp
Shiraga
Fumio
F
Yamaji
Hidetaka
H
Fukuda
Koki
K
Baba
Tetsuya
T
Takasu
Ippei
I
Ohtsuki
Hiroshi
H
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D004396:Coloring Agents; D003131:Combined Modality Therapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014822:Vitreous Body
D004396:Coloring Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green