Abstract

Since the first report on successful macular hole surgery in 1991, surgical techniques have been refined and have helped to increase anatomical and functional success rates. Macular hole surgery today consists of vitrectomy, internal limiting membrane peeling (especially in larger macular holes) with or without the use of vital dyes, such as indocyanine green, trypan blue or, as very recently suggested, brilliant blue, followed by endotamponade and prone position for a few days. Indocyanine green staining, in particular, has become a controversial subject of discussion as functional success might be diminished due to the phototoxic properties of the dye. Imaging techniques, such as optical coherence tomography, may not only serve as prognostic factors for visual recovery, but may also help to explain unsatisfactory visual recovery despite anatomical hole closure.

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