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

Purpose: To compare the results of surgery for macular hole with and without indocyanine green (ICG)-assisted intemal limiting membrane (ILM) peeling. Methods: Forty-six eyes of 43 patients with macular hole underwent pars plana vitrectomy, peeling of the posterior cortical hyaloid and epiretinal membrane, total fluid-gas exchange and positioning of face down for 10 days, of whom 23 eyes were treated with ILM peeling using ICG dye. Postoperative anatomic results, changes in best-corrected visual acuity, and complications of the macular holes surgery with ICG-assisted ILM peeling of 23 eyes and without ILM peeling of 23 eyes were compared. Results: In cases of performing ICG-assisted ILM peeling, anatomic closure was achieved in 18 eyes (78%) with single operation and 23 eyes (100%) with reoperation and two-line or more improvement was in 16 eyes (70%) during the mean follow-up of 9.2 months. In case of not performing ILM peeling, anatomic closure was in 16 eyes (70%) and two-line or more improvement was in 12 eyes (52%) during the mean follow-up of 9.5 months. Conclusions: Peeling of the internal limiting membrane using ICG was not statistically significant for anatomic or functional success. Further studies should be followed for the toxicity of ICG and ILM peeling associated with macular hole surgery.