ICG staining of the inner limiting membrane facilitates its removal during surgery for macular holes and puckers.

Formation of a macular hole is an uncommon idiopathic disease whereby a disruption of the neural retinal layer is formed at the foveal area. It has been suggested that tangential traction of the inner limiting membrane (ILM) on the neuroretina may contribute to the formation of a macular hole. Removal of the ILM has been associated with very high closure rates in macular hole surgery. However, since the inner limiting membrane is a transparent layer, it can be difficult to achieve complete removal from the underlying neural retina. Also in surgery for macular pucker formation, whereby growth of epiretinal tissue induces metamorphopsia, removal of the ILM may play a beneficial role. This paper describes a method facilitating the removal of the inner limiting membrane by staining it with indocyanine green.