Indocyanine green-assisted macular epiretinal membrane combined internal limiting membrane peeling for idiopathic macular epiretinal membrane

Abstract

Background Idiopathic macular epiretinal membrane (IMEM) occurs probably along with vitreous macular traction syndrome (VMTS),persudo macular hole (PMH) and lamellar macular hole (LMH).Removing posterior hyaloid and completely peeling IMEM are the key to the treatment.Objective This study was to investigate the effectiveness of indocyanine green (ICG)-assisted macular epiretinal membrane combined internal limiting membrane (ILM) peeling for IMEM.Methods Twenty nine eyes of 29 patients with IMEM were collected in Affiliated First Hospital of Zhengzhou University from June 2010 to September 2012,including 16 eyes with simple macular epiretinal membrane,6 eyes with both IMEM and VMTS,3 eyes with IMEM and PMH,4 eyes with IMEM and LMH.A standard three-port pars plana vitrectomy was performed.After removal of posterior hyaloid,0.25％ ICG was used to assist IMEM and ILM peeling.The process and results were recored.Results After staining,the free boundary of the IMEM became obvious and IMEM was peeled directly in 17 of the 29 eyes (58％).In the others (42％),a free petal of ILM was made,IMEM and ILM were peeled together.In all the 29 eyes,the peeled zone could be easily recognized.No serious intraoperative complication was found.The mean postoperative follow-up was (9.65 ±7.58)months (ranged,1 to 28 months).Visual acuity was improved in 20 eyes (69％).The LogMAR vision was significantly improved in postoperation in comprison with preoperation (0.62 ±0.56 versus 0.72 ±0.67) (t =2.370,P=0.025).No IMEM recurred during the following-up duration.Conclusions ICG-assisted ILM peeling can make the surgery of IMEM safer and prevent recurrence. Key words: Indocyaine green; Macular epiretinal membrane, idiopathic/surgery; Internal limiting membrane