Ahmed Awadein

Title: Vitrectomy guided by staining of the internal limiting membrane with indocyanine green Aim: To study the value of staining of ILM with ICG in macular hole surgery and to study the possible complications related to both peeling of ILM and to ICG Subject and Methods: The study was performed on 10 patients with idiopathic macular hole (group A) and 10 patients with traumatic macular hole (group B). All patients were subjected to pars plana vitrectomy followed by ICG-assisted peeling of the ILM. Anatomical success was assessed based on clinical examination and OCT. Visual improvement was measured in both groups. Possible complications related to ICG were studied by fluorescein angiography, visual field analysis and ERG. The removed ILM was examined by transmission electron microscopy Results: Closure of the macular hole was achieved in 80% of patients of group A and in 90% of patients of group B. Statistically significant improvement in visual acuity was obtained in patients of group A. Visual improvement in group B was nil. Fluorescein angiography showed perimacular hyperfluorescence in only 2 patients. Visual field showed improvement in macular sensitivity which correlated with both the anatomical success rate and the visual improvement. ERG showed improvement in 30-Hz flicker amplitude. The removed ILM showed proliferation of glial cells on the inner surface with no histopathological evidence of other retinal elements. Conclusion: ICG-assisted peeling of the ILM has given encouraging results in macular hole surgery, particularly in idiopathic macular hole.