Idiopathic Macular Hole Surgery with or without Indocyanine Green-Stained Internal Limiting Membrane Peeling

Purpose: To compare the anatomical and visual outcomes in idiopathic macular hole surgery with or without indocyanine green (ICG)-stained internal limiting membrane (ILM) peeling. Methods: Thirty-six eyes of 36 patients who underwent idiopathic macular hole surgery were included. Follow-up period was longer than 6 months. In the initial 16 eyes, no ILM peeling was performed (non-ILM peeling group). The subsequent 20 eyes underwent surgery with ICG-stained ILM peeling (ILM peeling group). Results: There were no significant differences in the age, sex, hole size, symptom duration and preoperative best-corrected visual acuity between the two groups. The anatomical closure rates were 95% (19/20eyes) and 75% (12/16eyes) in the ILM peeling and non-ILM peeling groups, respectively (Fisher's exact test, p=0.15). Visual improvement of two or more lines occurred in 35% (7/20eyes) in the ILM peeling group and 43.8% (7/16eyes) in the non-ILM peeling group (Chi-square test, p=0.59). Conclusions: ICG stained ILM peeling was not statistically significant for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of ICG and the result of ILM peeling should be performed.