Abstract
Purpose: :
To prospectively investigate macular function and morphology after surgical removal of idiopathic epiretinal membrane (IEM) with and without assistance of ICG.
Methods: :
A total of 42 patients, 22 female, 20 male, mean age 70 years, underwent standard 3–port pars–plana vitrectomy with removal of epiretinal membrane combined with standard phacoemulsification cataract surgery in the phakic patients. Patients were randomised to two groups: 23 patients were operated with ICG 0.1% in glucose 5% to stain the epiretinal membrane. 19 patients underwent the identical procedure but without use of ICG. Post–op follow–up was at 3–4 months. Functional outcome was assessed with subjective improvement, best–corrected visual acuity (BCVA), Amsler grid test, 10° and 30° automated perimetry (Heidelberg visual field analyser) (HFA) and Goldmann kinetic perimetry. Macular morphology was assessed with stereoscopic biomicroscopy and optical coherence tomography (OCT).
Results: :
BCVA improved in 35 patients, remained unchanged in 4 patients and decreased in 3 patients. Improvement of BCVA was statistically significant in both groups (p<0.01). Mean decimal BCVA in patients operated with ICG improved from preop 0.36 to postop 0.62 and without ICG from preop 0.39 to postop 0.69. Reduction of macular edema as measured by OCT was statistically significant in both groups (p<0.01). There was no statistically significant difference in postop BCVA, reduction of macular edema as measured by OCT, postoperative Amsler grid test, subjective improvement, and incidence of residual or recurrent epiretinal membrane between the two groups. Visual field defects were detected in 3 patients operated with ICG.
Conclusions: :
Removal of epiretinal tissue with or without assistance of ICG improved visual function and reduced macular edema in most patients. Adverse effects clearly attributable to the use of ICG were not observed.
Keywords: retina • macula/fovea • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials