Macular hole surgery with or without internal limiting membrane peeling / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To compare the anatomical and visual outcome in primary idiopathic macular hole surgery with or without indocyanine green (ICG) stained internal limiting membrane (ILM) peeling.METHODS: The medical records of the last 40 consecurive eyes receiving primary idiopathic macular hole surgery with gas as internal tamponade performed by a single surgeon were retrospectively reviewed and ahalyzed. All eyes had a follow-up of at least 6 months. In the initial 22 consecutive eyes, no ILM peeling was performed (non-ILM peeling group). The subsequent 18eyes underwent surgery with ICG stained ILM peeling (ILM peeling group).RESULTS: The primary anatomical closure rates were 88.9% and 59.1% in the ILM peeling group and non-ILM peeling group, respectively. The difference was statistically significant (Fisher′s exact test, P=0.038). Improvement in visual acuity was more marked in the ILM peeling group than in the non-ILM peeling group, with a mean improvement of 3.6 and 1.3 lines respectively (two-tailed t-test, P=0.036). There were significantly more cases with improvement of two or more lines of visual acuity after surgery, with 66.7% in the ILM peeling group and 31.8% non-ILM peeling group (Chi-square test P =0.028). However, there was no significant difference in the final postoperative logMAR BCVA between the two groups(two-tailed t-test, P=0.073).CONCLUSION: Based on this study, ICG stained ILM peeling seems to improve the anatomical and visual outcome in primary idiopathic macular hole surgery. Further studies in this aspect are warranted.