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Daniele Veritti, Giacomo Toneatto, Paolo Lanzetta; Twenty-five Gauge Transconjunctival Sutureless Vitrectomy with Low-concentration Infracyanine Green-assisted Internal Limiting Membrane Peeling in Idiopathic Macular Pucker: Outcomes and Predictive Factors. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4483.
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To investigate the safety and efficacy of 25-gauge infracyanine-green assisted idiopathic macular pucker surgery and to identify prognostic factors associated with visual outcomes.
Eighty-three patients with idiopathic macular pucker who underwent 25-gauge surgery with infracyanine-assisted internal limiting membrane peeling were retrospectively reviewed. Best-corrected visual acuity (BCVA) measurement, a complete ophthalmologic evaluation and optical coherence tomography were performed at baseline and during follow-up. Pre- and post-operative possible prognostic factors were correlated with final visual outcomes.
Mean follow-up was 10.5 months (range 3-44). BCVA improved by a mean of 0.3 ±0.25 logMAR (p <0.001), central retinal thickness (CRT) decreased by 86 ±105 µm on average (p <0.001). Greater post-operative visual gain was correlated with baseline BCVA (r =-0.65, p <0.0001) [Figure], BCVA gain after 1 week (r =0.64, p <0.0001) and 1 month (r =0.58, p <0.0001) and baseline CRT (r =-0.23, p =0.03). Final BCVA was influenced by baseline BCVA (r =0.46, p <0.0001), BCVA change after 1 week (r =0.25, p =0.02) and 1 month (r =0.34, p =0.002), baseline retinal sensitivity (r =0.24, p =0.03) and presence of intraretinal fluid (r =0.28, p =0.01). No cases of endophthalmitis, retinal tears, retinal detachments were reported.
Low-concentration infracyanine green-assisted internal limiting membrane peeling during minimally invasive surgery is associated with significant visual acuity improvement and no major safety concerns. Preoperative BCVA and OCT appearance may be helpful in predicting the final visual outcome.
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