Brilliant Blue G versus Triamcinolone-Assisted ILM Peeling: A Comparative Evaluation in Macular Hole Surgery

Abstract

Purpose: To evaluate and compare the anatomical and functional outcomes of internal limiting membrane (ILM) peeling in macular hole surgery (MHS) assisted by Brilliant Blue G (BBG) or triamcinolone acetonide (TA). Study design: Retrospective, non-randomized, interventional single center study. Methods: 51 eyes of 51 patients with idiopathic macular holes (≥ stage 2) who underwent MHS at our center were included. An OCT evaluation of hole status was followed by pars plana vitrectomy for each of these eyes. Those who underwent TA-assisted ILM peeling were considered as group 1 (n = 26) and those with BBG-assisted ILM peeling were considered as group 2 (n = 25). The primary outcome measures included anatomical hole closure, postoperative visual acuity and operative complications for either group. Results: Anatomical hole closure was achieved in 46 eyes (90%). The mean postoperative follow-up duration was 15.9 ± 2.3 months. The mean preoperative visual acuity was 1.0702 ± 0.37 Log MAR (equivalent to 20/240) and the final acuity was 0.7122 ± 0.22 Log MAR (equivalent to 20/100) (p < 0.0001). There were no significant postoperative complications apart from progression of nuclear sclerosis in 8/35 phakic eyes. After adjusting for age and preoperative visual acuity, there was no significant difference between the two groups with respect to hole closure rate and postoperative visual acuity. Conclusion: BBG-assisted ILM peeling offers an effective alternative to triamcinolone with the added advantage of marked enhancement of vitreoretinal interface contrast with comparable hole closure rates and visual outcomes.