Anatomical and visual outcomes of idiopathic macular hole surgery with internal limiting membrane removal using...

To report the anatomical, visual, and optical coherence tomography (OCT) results of using a brief application of a low concentration of indocyanine green (ICG) to assist the removal of internal limiting membrane (ILM) during idiopathic macular hole repair.

Retrospective, interventional, noncomparative case series of 59 eyes of 57 patients with stage 2, 3, or 4 idiopathic macular holes who underwent pars plana vitrectomy with removal of ILM assisted by a brief (<30 seconds) intravitreal application of 0.125% (1.25 mg/mL) ICG.

The median follow-up period was 13 months (range, 2-40 months). Anatomical closure of the macular hole was achieved in 58 eyes (98%) with a single surgery. Visual acuity improved from a preoperative mean of 20/100 to 20/60 postoperatively (P < 0.0001). Twenty-nine eyes (49%) had postoperative visual acuity of 20/50 or better. Visual acuity improved by > or =2 lines in 43 eyes (73%) and between 0 and 2 lines in 13 eyes (22%) and decreased in 3 eyes (5%). Postoperative OCT showed closure of macular hole with normal foveal depression in 49 (89%) of 55 eyes.

A brief application of ICG at a low concentration appears to provide a safe and effective way of assisting ILM peeling during idiopathic macular hole surgery.