The efficacy of triamcinolone-assisted vitrectomy and internal limiting membrane peeling for the treatment of large idiopathic macular holes

Objective To evaluate the effect of triamcinolone-assisted vitrectomy and internal limiting membrane peeling without dye for the treatment of large size stage IV idiopathic macular holes. Methods Twenty-seven eyes of 27 patients with stageⅣ idiopathic macular holes were collected.All patients underwent triamcinolone assisted vitrectomy, posterior vitreous detachment and internal limiting membrane peeling without dye.The best-corrected visual acuity (BCVA), intraocular pressure (IOP) and size of the macular hole measured with OCT before and after the surgery were analysed. Results The BCVA (logMAR) was 1.7-1.0, average of the BCVA was (1.2±1.3) before surgery.The BCVA (logMAR) was 1.6-0.8, average of the BCVA was (1.1±1.2) at 3 months after surgery.Compared with the preoperative level, the difference was statistically significant(t=3.38, P=0.027). Anatomic macular hole closure was achieved in 27 eyes(100%)at 2 weeks after surgeny, the difference in vision improvement was statistically significant (t=3.380, P=0 .027 ). The postopertive BCVA increased in 25 eyes (92.6%) and kept unchanged in 2 eyes (7.4%). No severe complications were noted. Conclusion Vitrious dyed by TA and vitrectomy ILM peeling without dye is an effective and safe surgical technique in stage Ⅳidiopathic macular holes. Key words: Macular hole, idiopathic, stage IV; Vitrectomy; Triamcinolone acetonide; Peeling, internal limiting membrane