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

Purpose: In this study, the outcome of internal limiting membrane (ILM) peeling in idiopathic macular hole surgery with or without indocyanine green (ICG) was investigated. Methods: Thirty eyes of 28 patients with idiopathic macular hole stage 3 or 4 who underwent vitrectomy were included. Follow-up duration in all cases was longer than 6 months. We analyzed the anatomical and functional results of macular hole surgeries using ILM peeling with (15 eyes) and without ICG (15 eyes). Results: There were no significant differences in sex, age, symptom duration, hole size, preoperative corrected visual acuity, or follow-up duration between the two groups. Anatomical success rates were 93.3% (14/15 eyes) in ILM peeling with ICG and 80.0% (12/15 eyes) in ILM peeling without ICG. In the cases of anatomical success, there was a statistically- significant difference between the functional success rates of 50.0% (7/14 eyes) in ILM peeling with ICG and 91.7% (11/12 eyes) in ILM peeling without ICG. Conclusions: While there was no statistically-significant difference in the anatomic success rate for idiopathic macular hole surgery with and without ICG, our results suggest the ILM peeling using ICG might produce a negative effect on functional success. Further studies are necessary to evaluation the toxicity of ICG in the context of macular hole surgery.