J Korean Ophthalmol Soc.  2005 Dec;46(12):1995-2003.

Comparison of Indocyanine Green and Triamcinolone Acetonide for Internal Limiting Membrane Peeling in Macular Hole

• Park UC
• Park KH
• Yu YS
• Chung H

Abstract

PURPOSE
To compare the surgical outcomes and complications of triamcinolone acetonide (TA) with those of indocyanine green (ICG) staining of the internal limiting membrane (ILM) during idiopathic macular hole surgery. METHODS: Twenty-four eyes of 23 consecutive patients with an idiopathic macular hole underwent vitrectomy, ILM peeling, and intravitreal gas injection. For enhanced visualization of ILM, ICG was used in 13 eyes and TA in the remaining 11 eyes. Functional and anatomical success rates and surgical complications were compared between the groups.
RESULTS
The mean follow-up periods were 10.8 months (ICG group) and 7.5 months (TA group). Best corrected visual acuity increased by two or more lines in 10 eyes (76.9%) of the ICG group and in eight eyes (72.7%) of the TA group (P=1.000). Anatomical closure after the first surgery was achieved in 10 eyes (76.9%) of the ICG group and in all 11 eyes of the TA group (100%) (P=0.223). Postoperative atrophic changes in the retinal pigment epithelium (RPE) in the macular hole bed was found in two eyes of the ICG group and in three eyes of the TA group. All of these (5 eyes) showed the photoreceptor outer segment defect in the closed macular areas by optical coherence tomography and had a postoperative best corrected visual acuity of 0.3 or less.
CONCLUSIONS
In view of the potential toxicities of ICG, TA appears to be a promising alternative adjuvant for ILM peeling during macular hole surgery. However, postoperative RPE atrophy was detected as a postoperative complication in both the ICG and TA groups. Further study is needed to evaluate the TA toxicity in macular hole surgery.

Keyword

Indocyanine green (ICG); Internal limiting membrane (ILM); Macular hole surgery; Retinal pigment epithelial atrophy; Triamcinolone acetonide (TA)

MeSH Terms

Atrophy
Follow-Up Studies
Humans
Indocyanine Green*
Membranes*
Postoperative Complications
Retinal Perforations*
Retinal Pigment Epithelium
Tomography, Optical Coherence
Triamcinolone Acetonide*
Triamcinolone*
Visual Acuity
Vitrectomy
Indocyanine Green
Triamcinolone
Triamcinolone Acetonide