The postoperative visual function's comparison of idiopathic macular hole by different concentration indocyanine green assisted internal limiting membrane peeling

Abstract

Objective To compare postoperative visual function of idiopathic macular hole(IMH)by different concentration of indocyanine green(ICG)solution assisted internal limiting membrane(ILM)peeling.Methods Forty-four cases(44 eyes)of IMH were randomly divided into four groups.Group Ⅰ:9 cases (9 eyes),Group Ⅱ:20 cases(20 eyes),Crroup Ⅲ:10 cases(10 eyes),group Ⅳ:5 cases(5 eyes).All patients underwent a three-port pars plana vitrectomy,ILM peeling and C3F8 tamponade.During the surgery,we used ICG solution to stain ILM,and the concentration of ICG solution was 5.0,2.5,1.25,0.5mg/ml respectively.In group Ⅰ,before using indocyanine-green to stain ILM,we used small amount of viscoelastic material to seal the macula hole temporarily.In group Ⅱ,Ⅲ andIV,we did not use any material to seal the macular hole during the surgery.After the surgery,the patients were followed-up regularly.Pre-operation and post-operation,we recordedthe patients' ratio of macular hole closure,vision,visual field examination and multifocal electroretinogram(MERG)examination.Results The ratio of macular hole closure was low in group Ⅳ.The postoperative best corrected vision in group Ⅲ was better than that in other three groups.The postoperative incidence of peripheral visual field loss in group Ⅰ and Ⅱ was significantly higher than that in group Ⅲ and IV.And the postoperative peak amplitude of MERG's second-order response of pefipheral retina was significantly lower than that of pre-operation in group Ⅰ and Ⅱ,but the peak amplitude of MERG's second-order response of peripheral retina was not significantly different with that of pre-operation in group Ⅲ and IV.Conclusions The assisted peeling of ILM by ICG solution of high concentration is toxic to the rotiBa and not good to the postoperative visual function recovery of macular hole patients.However,the assisted peeling of ILM by ICG solution of low concentration can significantly reduce the toxicity of ICG to retina,and not affect the postoperative visual function recovery of macular hole patients. Key words: Indocyanine green; Idiopathic macular hole; Visual function