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C.A. Baer, T.M. Aaberg, G.B. Hubbard, D.F. Martin, P. Sternberg, E. Garcia-Valenzuela; Modified ICG-Assisted ILM Peeling and Visual Acuity Outcomes in Macular Hole Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3002.
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Purpose: To determine whether ILM peeling with reduced concentration and incubation time of indocyanine green (ICG) affects visual acuity outcome in macular hole surgery. Methods: Retrospective study of patients with primary repair of an idiopathic macular hole with ILM peeling. Exclusionary criteria included: macular hole duration greater than 2 years, follow-up less than 2 months, presence of unrelated ocular pathology accounting for decreased visual acuity. Results: Of 52 eyes qualified and included for analysis, 15 (29%) underwent ICG assisted ILM peeling and 37 (71%) had ILM peeling without the use of ICG. The ICG was diluted to 50% of the dose in previous studies and was incubated for less than 1 minute. In this group, 11 of 15 eyes (73%) achieved and maintained a visual acuity at a level of 20/60 or better with a mean follow up of 5.9 months. In the group not receiving ICG, 26 of 37 eyes (70%) maintained a visual acuity at a level of 20/60 or better with a mean follow up of 10.9 months. Two of fifteen eyes (13%) and 7/37 (19%) developed recurrent holes in each group. Conclusions: The use of ICG to facilitate ILM peeling in macular hole surgery has been associated with atrophic retinal pigment epithelial changes. However, the preliminary results of this retrospective study suggest that ICG staining can be used in macular hole surgery without adversely affecting visual acuity outcomes, by modifying ICG concentration and incubation times.
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