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A. J. Barkmeier, M. J. Ko, P. E. Carvounis, J. L. Heffez, E. R. Holz; Vitrectomy and Internal Limiting Membrane Peeling for Vitreomacular Traction Syndrome With or Without Indocyanine Green Staining. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4439.
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© ARVO (1962-2015); The Authors (2016-present)
To compare functional results after vitrectomy and internal limiting membrane (ILM) peeling for vitreomacular traction syndrome (VMT) with or without indocyanine green (ICG) staining.
Retrospective, interventional, consecutive case series. Included were 29 eyes of 27 consecutive patients who underwent vitrectomy with internal limiting membrane peeling for vitreomacular traction at a single institution from 1998 - 2006. Patient demographics, medical and ocular history, and clinical data were recorded.
Mean pre-operative vision was 20/104 (logMAR 0.71), improving post-operatively to 20/59 at 1-3 months (logMAR 0.47, p=0.002), 20/49 at 3-6 months (logMAR 0.39, p<0.0001), 20/48 at one year (logMAR 0.38, p<0.0001), 20/48 at last follow-up (logMAR 0.38, p<0.0001), and 20/37 for the best post-operative acuity (logMAR 0.27, P<0.0001). Mean follow-up was 26.6 +/- 20.8 months. Pre- and post-operative OCT data were available for 8 eyes and demonstrated post-operative macular thinning from 559 +/- 239 to 219 +/- 72 microns (change of 340 +/- 229 microns, p=0.005). ICG staining was employed in 12 of 29 eyes. Mean pre-operative vision for eyes after ILM-peeling with and without the use of ICG was 20/124 and 20/92 (logMAR 0.79 and 0.66), improving to 20/49 and 20/59 at 1-3 months (logMAR 0.39 and 0.47), 20/47 and 20/51 at 3-6 months (logMAR 0.37 and 0.40), 20/41 and 20/53 at one year (logMAR 0.31 and 0.42), 20/42 and 20/53 at last follow-up (logMAR 0.33 and 0.42), and 20/36 and 20/40 for the best post-operative acuity (logMAR 0.26 and 0.31), respectively. Intergroup differences were statistically significant in favor of ICG-assisted ILM peeling at the one year (p=0.046) and final visits (p=0.039), but not for the early or best follow-up visits.
Excellent functional outcomes can be achieved with vitrectomy and ILM peeling for vitreomacular traction syndrome. No adverse outcomes clearly attributable to ICG were identified, and patient eyes in which ICG was employed for ILM peeling trended toward improved visual outcomes.
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