Anatomical and visual outcome of macular hole surgery with infracyanine green-assisted peeling of the internal limiting membrane, endodrainage, and silicone oil tamponade

Abstract

Purpose To evaluate the anatomical and visual outcome in macular hole patients who underwent surgery with infracyanine green-assisted internal limiting membrane peeling. Design A prospective case series with 51 consecutive eyes of 49 patients with idiopathic, iatrogenic, or traumatic Stage 2, 3, or 4 macular holes. Methods After removing the vitreous, in all eyes infracyanine green-assisted removal of the internal limiting membrane was performed. Patients older than 65 years of age underwent a simultaneous phacoemulsification. At the end of surgery, a silicone oil tamponade was used in all cases, and all patients were asked to position face down for 24 hours. Optical coherence tomography was performed preoperatively and postoperatively to determine the macular hole stage/size and the anatomical closure rate, respectively. Results The mean follow-up time was 9.8 months (range, 6–26 months). The overall median duration between the first symptoms and the surgery was 5 months. The overall anatomical success rate after one surgery was 92% (47 eyes), while that of chronic and nonchronic ones was 72.3% and 97.5%, respectively. The median preoperative visual acuity was 20/160 (range, 20/30 to counting fingers) and increased to 20/50 (range, 20/20 to 20/400) postoperatively. The mean increase in visual acuity was 3.7 lines (range, −4 to 10 lines). Of all 51 operated-on eyes, 26 (51%) eyes had a final visual acuity of 20/50 or better. Conclusions These findings indicate that infracyanine green-assisted removal of the retinal internal limiting membrane appears to induce a high incidence of anatomical closure, with good visual outcome.