A K H Kwok1, T Y Y Lai, V W Y Wong. 1. Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong. alvinkwok@hksh.com
Abstract
OBJECTIVE: To compare the anatomical and visual outcomes of primary idiopathic macular hole surgery usingindocyanine green-assisted internal limiting membrane peeling versus no internal limiting membrane peeling. DESIGN: Prospective randomised controlled clinical trial. SETTING:University teaching hospital, Hong Kong. PATIENTS: Fifty-one eyes of 49 Chinese patients with primary idiopathic macular hole were studied. INTERVENTIONS: Patients were randomised to undergo pars plana vitrectomy with indocyanine green-assisted internal limiting membrane peeling (26 eyes) or surgery without internal limiting membrane peeling (25 eyes). Perfluorocarbon gas was used in all cases as internal tamponade. MAIN OUTCOME MEASURES: Primary macular hole closure rate and best-corrected visual acuity. RESULTS: The mean follow-up duration was 12 months (range, 6-23 months). Respectively to the indocyanine green-assisted internal limiting membrane peeling group and non-internal limiting membrane peeling group, the primary anatomical closure rate was 92.3% and 32.0% (P<0.001), whereas improvement in best-corrected visual acuity was 3.7 and 1.5 lines (P=0.002). More eyes in the first group (84.6%) had improvement of 2 or more lines of best-corrected visual acuity after surgery than in the second group (32.0%) [P<0.001]. Multivariate logistic regression showed indocyanine green-assisted internal limiting membrane peeling was the only significant predictor for primary closure of the macular hole (adjusted odds ratio=30.8). CONCLUSION:Indocyanine green-assisted internal limiting membrane peeling in idiopathic macular hole surgery results in significantly better anatomical and visual outcomes compared with non-internal limiting membrane peeling in Chinese patients.
RCT Entities:
OBJECTIVE: To compare the anatomical and visual outcomes of primary idiopathic macular hole surgery using indocyanine green-assisted internal limiting membrane peeling versus no internal limiting membrane peeling. DESIGN: Prospective randomised controlled clinical trial. SETTING: University teaching hospital, Hong Kong. PATIENTS: Fifty-one eyes of 49 Chinese patients with primary idiopathic macular hole were studied. INTERVENTIONS:Patients were randomised to undergo pars plana vitrectomy with indocyanine green-assisted internal limiting membrane peeling (26 eyes) or surgery without internal limiting membrane peeling (25 eyes). Perfluorocarbon gas was used in all cases as internal tamponade. MAIN OUTCOME MEASURES: Primary macular hole closure rate and best-corrected visual acuity. RESULTS: The mean follow-up duration was 12 months (range, 6-23 months). Respectively to the indocyanine green-assisted internal limiting membrane peeling group and non-internal limiting membrane peeling group, the primary anatomical closure rate was 92.3% and 32.0% (P<0.001), whereas improvement in best-corrected visual acuity was 3.7 and 1.5 lines (P=0.002). More eyes in the first group (84.6%) had improvement of 2 or more lines of best-corrected visual acuity after surgery than in the second group (32.0%) [P<0.001]. Multivariate logistic regression showed indocyanine green-assisted internal limiting membrane peeling was the only significant predictor for primary closure of the macular hole (adjusted odds ratio=30.8). CONCLUSION:Indocyanine green-assisted internal limiting membrane peeling in idiopathic macular hole surgery results in significantly better anatomical and visual outcomes compared with non-internal limiting membrane peeling in Chinese patients.
Authors: Kamyar Vaziri; Stephen G Schwartz; Krishna S Kishor; Jorge A Fortun; Andrew A Moshfeghi; William E Smiddy; Harry W Flynn Journal: Ophthalmology Date: 2015-10-21 Impact factor: 12.079
Authors: Alfredo García-Layana; José García-Arumí; José M Ruiz-Moreno; Lluís Arias-Barquet; Francisco Cabrera-López; Marta S Figueroa Journal: J Ophthalmol Date: 2015-03-03 Impact factor: 1.909