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A. Tanikawa, N. Horio, T. Sugino, M. Horiguchi; Visual Function After Triamcinolone–Assisted Internal Limiting Membrane Peeling in Eyes With Idiopathic Macular Hole . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5529.
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Purpose: We reported that indocyanine green (ICG) dye used for internal limiting membrane (ILM) peeling affects visual outcome after macular hole surgery (Arch Ophthalmol 2004), and introduced the use of triamcinolone acetonide (TA) for visualizing the ILM (Arch Ophthalmol in press). The purpose of this study is to evaluate postoperative visual function after TA–assisted ILM peeling. Methods: Thirty–four eyes of 34 patients underwent vitrectomy with phacoemulcification and intraocular lens implantation due to idiopathic macular hole, and were followed for more than 1 year. In 16 eyes (Group A), TA–assisted ILM peeling was performed using 8 mg/ml TA suspension to make the ILM more visible. In 18 eyes (Group B), ILM peeling was performed without TA or ICG. There were no differences in preoperative visual acuity (Group A ranging from 20/220 to 20/40, Group B ranging from 20/250 to 20/70), size or stage of macular hole, age, gender, or follow–up period. Routine examinations were repeated during the follow–up period, and multifocal electroretinogram was performed. Results: In all eyes, macular hole was closed, and postoperative visual acuity was higher than preoperative visual acuity by 2 or more lines. No difference was found in postoperative visual acuity between Group A, ranging from 20/40 to 20/15, and Group B, ranging from 20/40 to 20/15 using Mann–Whitney U–test. There was no difference in the improvements of visual acuity between Group A (0.72 ± 0.2 in log MAR) and Group B (0.79 ± 0.16) using t–test. No differences were found in the amplitudes or implicit times of the multifocal electroretinograms. No atrophic retinal pigment epithelium change was found using an ophthalmoscope. Conclusions: Our data suggested that TA can be used for visualizing the ILM without affecting visual outcome.
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