Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Controversy in Macular Hole Surgery: Internal Limiting Membrane Maculorhexis with or without Indocyanin Green? Are there any Differences in the Anatomical or Functional Outcome?

Schrader W. F., Janzen F.
Department of Ophthalmology, Wuerzburg University

Purpose: Since macular hole surgery was first described by Kelly and Wendell in 1991, various techniques have been proposed. According to a metaanalysis by Kuhn and Mester [2000] the best anatomic and functional results results are achieved with ILM peeling. Indocyanine green (ICG) has been used as a dye to facilitate the removal of the internal limiting membrane (ILM) in macular hole surgery, but is now suspected for causing toxic effects on the retinal function. We compared our functional and anatomical results of macular hole surgery with internal limiting membrane maculorhexis with and without ICG.
Method: We compared the anatomical and functional results of 100 consecutive patients (105 eyes) with macular hole stage 2 - 4 (Gass) with pars plana vitrectomy, peeling of epiretinal membranes and of the internal limiting membrane by maculorhexis, SF6 injection and prone positioning of the patient for 8 days with 53 consecutive patients (54 eyes) treated with the same technique, but with ICG to stain the ILM. Median follow up was 11 months (3 - 51 months). Both series were operated by the same surgeon.
Results: ICG in macular hole surgery facilitates the peeling of the ILM. Howeve, ICG is of no significant influence on the anatomical and functional outcome. Without ICG, macular hole closure was achieved in

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