Análise comparativa da cirurgia do buraco macular associada à remoção da membrana limitante interna com e sem coloração pela indocianina verde

Abstract

To describe comparatively the outcomes of macular hole surgery followed by internal limiting membrane removal with and without indocyanine green staining. We evaluated 142 consecutive macular hole surgeries with internal limiting membrane removal performed in the period from January 2001 to March 2004. These were divided into two groups, based on the use or not of indocyanine green staining. Both studied groups were similar concerning the patients' profile and preoperative stage of the macular holes. Mean preoperative visual acuity was 0.12+/-0.15 in the group with indocyanine green staining and 0.18+/-0.18 in the group without internal limiting membrane staining (p=0.02). Mean postoperative visual acuity was 0.27+/-0.27 in the group with internal limiting membrane staining and 0.43+/-0.25 in the group without internal limiting membrane staining (p=0.0002). We observed improvement of visual acuity in 63% of cases in the group in which internal limiting membrane staining was performed and in 80.3% of cases in the group without internal limiting membrane staining. Macular hole closure rates were 76.5% in the group treated with internal limiting membrane staining and 95.1% in the group treated without internal limiting membrane staining. Macular hole surgeries followed by internal limiting membrane removal without use of staining have better visual and anatomic results when compared to macular hole surgeries followed by internal limiting membrane removal guided by indocyanine green staining. We recommend caution in using indocyanine green staining in macular hole surgeries due to its possible toxic effect.