Macular hole surgery with and without infracyanine-green-guided removal of the internal limiting membrane

To investigate the possibility of an adverse effect of infracyanine-guided internal limiting membrane (ILM) removal on functional results of macular hole surgery. A retrospective study of two consecutive groups of patients operated for macular hole between January 1998 and December 2001. In group 1 (21 patients), no attempt was made to remove the internal limiting membrane. In group 2 (21 patients), the ILM was peeled using infracyanine green (ICG). In group 1, 17 of 21 (81%) macular holes were closed by one surgery and 20 of 21 (95%) in group 2; however, this was not statistically significant. Mean preoperative visual acuity was close to 1 on the Logmar scale in both groups. Postoperative visual acuity was 0.6 in group 1 and 0.5 in group 2: four Snellen lines of improvement in group 1 and five lines in group 2. Postoperative visual acuity was the same or better in 16 of 21 patients in group 1 and in 18 of 21 in group 2. These differences were not statistically significant. Late reopening of the hole was statistically less frequent in group 2. Three cases of atrophic patterns at the level of foveal pigment epithelium were noted in each group as was one case of phototraumatism in group 1. These results were stable after more than 18 months of follow-up. All eyes became pseudophakic. In this study, infracyanine-guided removal of the internal limiting membrane did not significantly improve the results of macular hole surgery. No adverse effect of infracyanine on visual function or retinal toxicity was found and late reopening was less frequent.