Clinical Study
Eye (2005) 19, 279–283. doi:10.1038/sj.eye.6701455 Published online 2 July 2004
Visual outcomes following ICG assisted ILM peel for Macular Hole
Previously presented as a poster at the Royal College of Ophthalmologists Annual Congress in Birmingham, May 2003
D Posselt1, R Rahman1, M Smith1 and P R Simcock1
1West of England, Eye Unit, Royal Devon and Exeter Hospital, UK
Correspondence: PR Simcock, West of England, Eye Unit, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK. Tel: 044 1392406008; Fax: 044 1392406022; E-mail: psimcock@hotmail.com
Received 1 July 2003; Accepted 12 January 2004; Published online 2 July 2004.
Abstract
Purpose
To evaluate the anatomical and visual outcome of indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling for macular hole surgery. A literature search identified potential factors that may affect the functional success of the procedure.
Methods
Retrospective case note review of 14 consecutive patients undergoing phaco-vitrectomy, gas and ICG-assisted ILM peeling for macular hole from July 2001 to July 2002. A 0.5% ICG solution (osmolarity 270 mOsm) was left in contact with the retina for 1–3 min. The outcome measures were hole closure, change in visual acuity, and macular pigmentary changes.
Results
Anatomical hole closure was achieved in 13 of 14 eyes (92.8%). The mean logMAR Snellen acuities were 0.80 (range 0.60–1.30) preoperatively and 0.77 (0.48–1.30) postoperatively. Seven eyes (50%) developed retinal pigmentary changes in the macular area
Conclusions
ICG-assisted ILM peeling for macular hole surgery achieves high rates of anatomical hole closure, but functional results are less encouraging. Previous studies suggest toxicity of the ICG to the retina, at the level of the RPE or inner retina. The results may be optimized by using a lower concentration, iso-osmolar, viscous solution, and by minimizing contact time of the solution and intensity, and duration of illumination.
Keywords:
macular hole, ICG, ILM
