Abstract
Purpose: :
To compare surgical outcomes of eyes with vitreomacular traction syndrome (VMTS) treated with and without Indocyanine Green (ICG)–assisted Internal Limiting Membrane (ILM) peeling.
Methods: :
A retrospective review of patient charts, operative reports, photographs, and optical coherence tomography images was performed for all patients diagnosed with VMTS and treated surgically by three surgeons at the Baylor College of Medicine from July 1996 to July 2005. Ninety–two eyes of 80 patients were in the study group. Forty–eight eyes were treated with vitrectomy and posterior hyaloid separation alone (Group 1); forty–four eyes were treated with vitrectomy, posterior hyaloid separation and ICG–assisted ILM peeling (Group 2). Mean follow–up time was 36 months (range, 12–62 months) overall. Group 1 follow–up was 33 months (range, 16–62 months) and Group 2 follow–up was 28 months (range, 12–52 months).
Results: :
Complete posterior vitreous separation and macular reattachment was achieved in all VMTS eyes. Seventy–nine eyes (86%) achieved two or more lines of visual improvement: Thirty–seven eyes in Group 1 (77.1%) and 42 eyes in Group 2 (95.5%). Mean macular thickness at one year as measured by OCT was 222.5 µm in Group 1 eyes and 134.5 µm in Group 2 eyes. Twenty–six eyes (28.3%) developed symptomatic epiretinal membranes with thickening on OCT by one year: Twenty eyes in Group 1 (77.0%) had a mean macular thickness of 255.4 µm and 6 eyes in Group 2 (23.1%) had a mean macular thickness of 173.5 µm.
Conclusions: :
Treatment of VMTS with ICG–assisted ILM peeling may improve visual outcomes and reduce the incidence of re–proliferation of glial tissue resulting in postoperative epiretinal membranes.
Keywords: vitreoretinal surgery • retinal adhesion • macula/fovea