Comparison of Outcomes of ILM Peeling Using Triamcinolone and Indocyanine Green during Idiopathic Macular Hole Surgery

PURPOSE: To compare the outcomes of indocyanine green (ICG) and triamcinolone (TA) assisted internal limiting membrane (ILM) peeling during idiopathic macular hole surgery. METHODS: Fifty-four eyes of 54 patients with idiopathic macular hole underwent pars plana vitrectomy including peeling of the posterior cortical hyaloid and peeling of the internal limiting membrane. For enhanced visualization of ILM, ICG was used in 25 eyes and TA in the remaining 29 eyes. Postoperative visual acuity was measured and OCT was performed. RESULTS: Anatomical closure was achieved in 25 eyes (100%) in ICG group and 28 eyes (97%) in TA group, Best corrected visual acuity improvement by > or =2 lines was in 15 eyes (60%) in ICG group and 18 eyes (62%) in TA group. Postoperative visual improvement rates by > or =20/50 were 10 eyes (40%) in ICG group and 9 eyes (31%) in TA group. CONCLUSIONS: Peeling of the internal limiting membrane using triamcinolone and indocyanine green was safe and effective for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of TA, ICG and the result of internal limiting membrane peeling is needed.

A Case of Posterior Capsule Rupture after Blunt Ocular Trauma in a Child

PURPOSE: To report a case of isolated posterior capsule rupture (PCR) with cataract after blunt ocular trauma in a child. METHODS: A 6-year-old female visited our institution complaining of blurred vision (best corrected visual acuity: counting fingers at 30 cm) in the left eye three months after blunt ocular trauma. Slitlamp examination showed the cataract and PCR with intact anterior capsule. Removal of the cataract was approached via a scleral tunnel incision. Anterior vitrectomy was performed and a foldable intraocular lens (IOL) was inserted in the sulcus. RESULTS: Visual acuity was improved to 0.7 two days after the surgery and further improved to 1.0 at two months. CONCLUSIONS: An isolated PCR with cataract is a rare complication of blunt ocular trauma. We present a case of PCR after blunt ocular injury as well as a surgical procedure to safely remove the cataract via an anterior approach and implantation of the IOL in the sulcus.