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C.F. M. Meulendijks, M.A. D. Tilanus, T. Theelen, C.B. Hoyng; Autologous blood platelets versus ICG–assisted inner limiting membrane (ILM) peeling in patients with idiopathic macular holes . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1986.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To compare the functional (visual) results of surgery for idiopatic stage 3 macular holes, either performed with autologous platelets application or ICG–assisted inner limiting membrane (ILM) peeling. Methods:The charts of 78 patients who underwent surgery for idiopathic macular hole at our department were reviewed. All cases were operated on by one of the authors (MT). All patients underwent pars plana vitrectomy (PPV) with posterior vitreous detachment (PVD) and intraoculair gas tamponade with C2F6–gas. All patients kept face–down position for 5 days postoperatively. Two different surgical groups were analyzed. Group A consisted of 39 successive eyes operated on between January 1998 and December 1999. These patients received autologous platelets application intraoperatively. Group B included 39 consecutive patients where additional ICG–assisted ILM peeling was performed. The latter had surgery between January and December 2001. Data collection consisted of age, sex, preoperative best corrected visual acuity (BCVA), lens status, complications, closure and postoperative BCVA after a minimum follow–up period of three months after macular hole surgery or after subsequent cataract surgery in phakic patients. Main outcome measures were anatomic success in terms of macular hole closure, and functional success, defined as improving at least three log MAR lines. Results:No differences in baseline characteristics existed. There was no significant difference in anatomical succes rates between both groups. However, the number of patients with functional improvement of at least three lines was higher in group A. In addition, more patients reached a visual acuity of at least 20/40 in the autologous platelets group. Conclusions:In this retrospective study the use of autologous platelets is superior to ICG–assisted peeling of the ILM in terms of functional success. This may be due to the presumed (photo) toxicity of ICG.
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