To evaluate functional and anatomical outcome of triamcinolone acetonide assisted internal limiting membrane (ILM) peeling in patients with macular hole.
Fifteen eyes of 15 consecutive patients were identified with stage 3 and 4 idiopathic macular holes, these undergoing triamcinolone acetonide assisted ILM peeling for macular holes. These were matched retrospectively with 15 eyes of 15 patients with stage 3 and 4 idiopathic macular holes of less than six months duration, who underwent macular hole surgery with ILM peel augmented with indocyanine green (ICG). Functional and anatomical outcomes were compared between two groups.
There were no significant differences between the two groups with reference to demographic features of age, sex, staging of the macular holes and the proportion subsequently undergoing cataract surgery. The mean follow-up period was 6.4 months in the triamcinolone acetonide group and 7.2 months in the ICG group. The hole closure rate was 100% in both group at primary operation. The mean Snellen line change was +1.24 in the intravitreal triamcinolone group and +1.1 in the ICG group. There was a significant improvement in Snellen and Logmar visual acuity in both groups. These differences in visual outcome between the groups were not statistically significant.
Our data showed similar outcomes for patients with macular hole where ICG has been used when compared to patients where triamcinolone acetonide has been used for ILM peeling. Further study with longer follow-up and large series is warranted to assess the safety of the triamcinolone acetonide assisted ILM peeling in macular hole surgery.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Brooks HL Jr (2000) Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 107:9–43
Engelbrecht NE, Freeman J, Sterberg P Jr et al. (2002) Retinal pigment epithelial changes after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 133:89–94
Flaser E, Cheema RA, Roberts MA (2003) Triamcinolone acetonide-assisted peeling of retinal internal limiting membrane for macular surgery. Retina 23:883–884
Freeman WR, Azen SP, Kirn JW, El-Haing W, Mischell DR III, Bailey I (1997) Vitrectomy for the treatment of full-thickness stage 3 or 4 macular holes. Results of a multicentre randomized controlled trial. The vitrectomy for the treatment of macular hole study group. Arch Ophthalmol 115:11–21
Gandorfer A, Messmer EM, Ulbig MW, Kampik A (2001) Indocyanine green selectively stains the internal limiting membrane. Am J Ophthalmol 131:387–388
Haritoglou C, Gass CA, Schaumberger M, Gandorfer A, Ulbig MW, Kampik A (2002) Long term follow-up after macular hole surgery with internal limiting membrane peeling. Am J Ophthalmol 134:661–666
Ho AC, Yannuzzi LA, Guyer DR (1994) Intraretinal leakage of indocyanine green dye. Ophthalmology 101:534–541
Ip MS, Baker BJ, Duker JS, Reichel E, Baumel CR, Gangon R et al. (2002) Anatomical outcomes of surgery for idiopathic macular holes determined by optical coherence tomography. Arch Ophthalmol 120:29–35
Kadonosono K, Itoh N, Uchio E, Nakamura S, Ohno S (2001) Staining of the internal limiting membrane in macular hole surgery. Arch Ophthalmol 118:1116–1118
Kimura H, Kuroda S, Nagata M (2004) Triamcinolone acetonide-assisted peeling of the internal limiting membrane. Am J Ophthalmol 137:172–173
Park DW, Sipperley JO, Sneed SR, Dugel PU, Jacobsen J (1999) Macular hole surgery with internal limiting membrane peeling and intravitreous gas. Ophthalmology 106:1392–1397
Peyman GA, Cheema R, Conway MD, Fang T (2000) Triamcinolone acetonide as an aid to visualization of the vitreous and the posterior hyaloid during pars plana vitrectomy. Retina 20:554–555
Sippy BD, Engelbracht NE, Hubbard GB et al. (2001) Indocyanine green effect on cultured human retinal pigment epithelial cell: implication for macular hole surgery. Am J Ophthalmol 132:433–435
Smiddy WE, Feuer W, Cordahi G (2001) Internal limiting membrane peeling in macular hole surgery. Ophthalmology 108:1471–1478
Tadayori R, Paques M, Girmens JF, Massin P, Gaudic A (2003) Persistence of fundus fluorescence after use of indocyanine green for macular surgery. Ophthalmology 110:604–608
Weinberger AW, Kirchof B, Mazinani BE, Schrage NF (2001) Persistent ICG fluorescence 6 weeks after intraocular ICG administration for macular hole surgery. Graefe Arch Clin Exp Ophthalmol 239:388–390
Yam HF, Kwok AK, Chan KP et al. (2003) Effect of indocyanine green and illumination on gene expression in human pigment epithelial cells. Invest Ophthalmol Vis Sci 44:370–377
The authors have no commercial interest in the material used in this work.
About this article
Cite this article
Karacorlu, M., Ozdemir, H. & Arf Karacorlu, S. Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?. Graefe's Arch Clin Exp Ophthalmol 243, 754–757 (2005). https://doi.org/10.1007/s00417-005-1133-x
- Triamcinolone acetonide
- Internal limiting membrane
- Macular hole