Three Year Follow-up of Macular Hole Surgery Without ILM Peeling, and With ILM Peeling With and Without ICG Dye

Abstract

Purpose:: To compare the anatomical closure and the visual outcome after macular hole surgery among three groups; those (1) without internal limiting membrane (ILM) peeling, (2) with ILM peeling with the use of indocyanine green (ICG) dye, and (3) with ILM peeling without ICG dye.

Methods:: Seventy-five eyes of 71 patients with stage 2, 3, and 4 idiopathic macular hole underwent vitrectomy with gas (C₃F₈ or SF₆) tamponade between May 1996 to September 2002. In total, 21 eyes of 21 patients underwent vitrectomy without ILM peeling (Group A), 16 eyes of 14 patients underwent vitrectomy with the use of 0.25% ICG (Group B), and 38 eyes of 37 patients underwent vitrectomy with ILM peeling without the use of ICG (Group C). The main outcome measures were anatomical results, and best-corrected visual acuity (BCVA) at 1 year, 2 years, and 3 years after surgery.

Results:: The macular hole was closed in all 75 eyes after a single surgery. BCVA improved significantly at 1 year after surgery, and remained unchanged at 2 and at 3 years after surgery for all three groups. Among the three groups, there was no significant difference both in the BCVA at 1, 2, and 3 years after surgery, and in the improvement of BCVA at 1, 2, and 3 years after surgery.

Conclusions:: Three-year follow-up of patients undergoing macular hole surgery showed that there was no significant difference both in the anatomical closure and visual acuity between without ILM peeling, with ILM peeling with the use of ICG, and with ILM peeling without the use of ICG.

Keywords: macular holes • visual acuity • vitreoretinal surgery