Abstract
Abstract: :
Purpose: To examine visual outcomes using different surgical techniques in macular hole surgery, including internal limiting membrane (ILM) peeling and staining with indocyanine green (ICG) dye. Methods: Retrospective review of 79 consecutive patients undergoing macular hole repair over a 27 month period. All cases underwent pars plana vitrectomy with removal of the posterior hyaloid. 83 eyes were divided into 3 groups – Group 1 (n=24): no ILM peeling; Group 2 (n=20): ILM peeled without the prior instillation of ICG; Group 3 (n=39): ILM peeled with prior instillation of ICG. Results: The average change in visual acuity was an improvement of 3.7 lines in Group 1, 4.3 lines in Group 2, and 2.9 lines in Group 3 (p = 0.18). The percentage of eyes with improvement in visual acuity > 2 lines was 75%, 90% and 69% for Groups 1, 2 and 3, respectively. The hole closure rate was 96% for Group 1, 95% for Group 2 and 100% for Group 3. Conclusions: All 3 techniques were associated with good hole closure rates and lead to visual improvement in the majority of cases. ILM peeling alone (Group 2) was not harmful to final visual outcome, with results similar to no peeling (Group 1). The use of ICG (Group 3) may have had a less beneficial effect on visual outcome. A larger proportion of patients in Group 3, however, presented with difficult or atypical cases, which may partly account for their lower rate of improvement. Additional patients in all groups will be studied.