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Indocyanine Green Affects Functional Outcome in Macular Hole Surgery
Gass C. A., Haritoglou C., Schaumberger M., Kampik A.,
Ludwig-Maximilians-Universität München, Klinikum Innenstadt, Augenklinik (München)
Purpose: To compare functional outcome following anatomically successful macular hole surgery with and without indocyanine green (ICG) staining of the internal limiting membrane (ILM).
Method: Functional outcome of 18 patients after ICG assisted vitrectomy (group 2) was retrospectively analysed (Goldmann perimetry, visual acuity). Results were compared to a consecutive series of patients who had undergone surgery before (group 1, n = 22) and after (group 3, n = 17) the use of ICG in our institution. No other changes concerning the operative technique - except the use of ICG - were made. Statistical analysis was performed using SPSS for Windows.
Results: Preoperatively, no statistically significant difference in visual acuity between the three groups was observed (median 0.2; p > 0.5). Median postoperative visual acuity in both groups without the intraoperative use of ICG improved to 0.5 (gain in lines: 4,5 lines in group 1 and 5 lines in group 2 respectively). In patients after ICG application vision remained unchanged. The difference was statistically significant (p < 0.001). Median follow-up time was 6 months in all groups, all patients were pseudophacic. Large visual field defects were noted only after ICG application (group 2, n = 9/18).
Conclusions: ICG affects functional outcome in macular hole surgery. While the underlying mechanism remains unclear, changes in our operative technique can be ruled out as a possible source of damage by the data presented.