Surgical effects and complications of indocyanine green‐assisted internal limiting membrane peeling for idiopathic macular hole

Abstract

To compare the surgical outcomes and complications of vitrectomy with internal limiting membrane (ILM) peeling with or without indocyanine green (ICG) staining in eyes with an idiopathic macular hole. This study involved a non-randomized, single-centre, retrospective, interventional case series. Rates of anatomical closure, visual acuities (VAs) and postoperative complications in 35 eyes of 31 patients who underwent ICG-assisted ILM peeling during macular hole surgery (stained group) were compared with those in 18 eyes of 16 patients who underwent the same procedure without ICG staining (non-stained group). Macular holes were closed following the initial surgery in 97% of the stained group and 94% of the non-stained group (p > 0.999). There was no significant difference in mean final VA between the stained and non-stained groups, but there was a lower percentage of eyes with postoperative vision > 20/25 in the stained group (15%) than in the non-stained group (44%) after 2 years (p = 0.036). Posterior retinal pigment epithelium atrophy, retinoschisis and visual field defects were observed only in the stained group. The difference in mean final VA between the two groups was not significant. However, a lower percentage of eyes obtained VA > or = 20/25 and a higher incidence of postoperative complications occurred in the stained group. These results indicate that some consideration should be made before ICG is used in macular hole surgery.