Abstract
Abstract: :
Purpose: To evaluate the efficacy of pars plana vitrectomy with infracyanine green–assisted internal limiting membrane peeling for the treatment of idiopathic macular hole. Methods: Noncomparative interventional case series. Thirty–one consecutive eyes of 28 patients with idiopathic macular hole were included in the study. Patients underwent ETDRS visual acuity examination, dilated ophthalmoscopy, and optical coherence tomography before treatment and during follow–up. Fluorescein angiography was done in selected cases. Patients underwent a three–port pars plana vitrectomy with complete posterior hyaloid and epiretinal membrane removal. The internal limiting membrane was stained with infracyanine (0.5 mg/ml) and peeled up to the vascular arcades. C3F8 10% was used as tamponade. Results: Mean follow–up was 9 ± 5 months (range 3–24). Five eyes had stage 2 macular hole, 23 eyes stage 3 and 3 eyes stage 4. Fourteen eyes received cataract surgery at the time of vitrectomy, seven eyes had cataract removed during follow–up and 10 eyes remained phakic. Overall, 30 of 31 macular holes closed with one operation. Median visual acuity was 20/100 (range 20/400– 20/50) before surgery and 20/50 (range 20/650– 20/25) after surgery. Visual acuity after surgery was 20/50 or better in 19 of 31 (61.3%) eyes. Seventeen (55%) eyes improved by two or more lines, 11 (35%) eyes were stable, and 3 (10%) eyes worsened by two or more lines due to retinal detachment, cataract progression and unexplained atrophy of the retinal pigment epithelium, respectively. No other complications were observed. Conclusions:Although the follow–up time and number of patients in this pilot study are limited, the encouraging results suggest that infracyanine green–assisted peeling of the internal limiting membrane may be useful in the treatment of idiopathic macular hole. Further studies are indicated.
Keywords: macular holes • vitreoretinal surgery • retina