Internal Limiting Membrane Removal during Macular Hole Surgery

Tognetto, Daniele; Grandin, Rosita; Sanguinetti, Giorgia; Minutola, Daniela; Nicola, Marta Di; Mascio, Rocco Di; Ravalico, Giuseppe

doi:10.1016/j.ophtha.2006.02.061

Cited by 165 publications

(110 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 Further, in the holes that did close, visual outcome was significantly worse if ICG was used: 67% of the no-ICG group obtained two logMAR lines of improvement compared with 56% in the ICG group. This study was designed to compare ILM peeling with no peeling, rather than to look for ICG toxicity.…”

Section: Visual and Anatomic Outcomementioning

confidence: 92%

“…61 A large non-randomized study found that ICG was associated with lower rates of anatomic success, and worse acuity in those eyes with closed holes. 21 The large number of non-randomized, observational studies are all potentially subject to selection bias, publication bias, and confounding, and many were not adequately powered. Their findings differ widely, but the most common observation appears to be visual field defects.…”

Section: Summary Of Icg Clinical Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Stanescu-Segall

Jackson

2008

Eye

View full text Add to dashboard Cite

Indocyanine green (ICG) is extremely effective when used as a vital stain during macular hole surgery. By staining the internal limiting membrane, ICG facilitates removal of this delicate and sometimes hard to visualize structure. There is, however, considerable debate regarding its safety. This review considers the clinical and experimental studies of ICG and a related agent, infracyanine green. Some clinical papers show visual field defects, reduced visual acuity, and persistence of ICG at the macula and optic nerve. Other clinical studies fail to demonstrate toxicity. The experimental studies are also conflicting, but there are emerging trends. These suggest that surgeons who continue to use ICG should use concentrations not greater than 0.05 mg/ml, in fluid-filled eyes, with short exposure times, iso-osmolar solutions, and avoid proximal or prolonged endoillumination of stained tissue. A smaller number of studies suggest that infracyanine green produces similar staining to ICG, and may possibly be safer, but there are too few well-designed studies to reach a conclusion. Although the use of ICG continues, on the balance of evidence, this review suggests that it is has the potential to produce subtle visual damage.

show abstract

Section: Visual and Anatomic Outcomementioning

confidence: 92%

Section: Summary Of Icg Clinical Studiesmentioning

confidence: 99%

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Stanescu-Segall

Jackson

2008

Eye

View full text Add to dashboard Cite

show abstract

“…This may be comparable to reported rates of closure in investigations in which ILM peeling was performed. 37 In our study, the remaining 6.0% of eyes with persistently open MHs were closed with an additional procedure in which standard complete ILM peeling was performed. Our hypothesis is that in this subset of patients with unsuccessful primary MH closure the ILM and membrane remained intact, and there was inadequate removal of the tractional forces.…”

mentioning

confidence: 82%

“…We did not have a control group for comparison that underwent standard ILM peeling and it has been suggested that complete ILM peeling may ensure long-term closure rates. 37 …”

mentioning

confidence: 99%

Macular Hole Closure With Internal Limiting Membrane Abrasion Technique

et al. 2015

View full text Add to dashboard Cite

Internal limiting membrane (ILM) abrasion is an alternative surgical technique for successful full-thickness macular hole (MH) repair. OBJECTIVE To study the effects of ILM abrasion as an alternative method of MH repair. DESIGN, SETTING, AND PARTICIPANTS Retrospective consecutive case series from January 2006 to December 2008. Demographic data and preoperative, intraoperative, and postoperative examination records of all patients were reviewed for patients who underwent ILM abrasion with a diamond-dusted membrane scraper during vitrectomy for MH repair. A total of 100 eyes underwent ILM abrasion as an alternative to traditional ILM peeling. MAIN OUTCOMES AND MEASURES Rate of MH closure and visual acuity (VA) outcomes at 3 months after surgery.RESULTS Macular hole closure was achieved with a single surgical procedure in 94 of 100 eyes (94.0%; 95% CI, 87.4%-97.8%). Among all patients, the median preoperative VA was 20/100 (range, 20/30 to hand motions; 25th quartile, 20/60; and 75th quartile, 20/160), and the median postoperative VA at 3 months after surgery was 20/60 (range, 20/20 to hand motions; 25th quartile, 20/40; and 75th quartile, 20/100). Among all patients with stage 2 MHs, 30 of 38 patients (78.9%) had at least 2 lines of VA gain: 15 of 23 (65.2%) were phakic, and 15 of 15 (100%) were pseudophakic. Four of 38 patients (10.5%) with stage 2 MHs had at least 2 lines of VA loss, and all were phakic. Among all patients with stage 3 or 4 MHs, 42 of 62 (67.7%) had at least 2 lines of VA gain, of which 30 of 38 (78.9%) were phakic and 22 of 24 (91.7%) were pseudophakic. Six of 62 patients (9.7%) with stage 3 or 4 MHs had at least 2 lines of VA loss: 4 were phakic, and 2 were pseudophakic. In total, 35.0% (95% CI, 25.7%-44.3%) of patients achieved 20/40 vision or better, and 52.0% (95% CI, 42.2%-61.8%) of patients achieved 20/50 vision or better.CONCLUSIONS AND RELEVANCE Abrasion of the ILM with a diamond-dusted membrane scraper at the time of vitrectomy achieves high rates of MH closure. This technique avoids complete removal of the retinal ILM basement membrane and subjacent tissues and appears to provide MH closure rates similar to those of traditional ILM peeling.

show abstract

“…We investigated the healing process of foveal microstructures and visual acuity pre-and post-operatively at 1, 3, 6, 12 months after surgery. We evaluated the integrity of four factors by OCT image: existence of MH (Hole, H1,3,6,12), recovery of outer nuclear layer (ONL, O1,3,6,12), recovery of external limiting membrane (ELM, E1,3,6,12), and recovery of inner segment-outer segment (IS/OS) line of the photoreceptor (Photoreceptor, P1,3,6,12). We compared the recovery course and visual acuity of the four groups based on postoperative 12 months.…”

Section: Purposementioning

confidence: 99%

Recovery Course of Macular Structure after Macular Hole Surgery: Using a Spectral Domain Optical Coherence Tomography Image

Woo

Hong

Jang

2016

J Korean Ophthalmol Soc

View full text Add to dashboard Cite

Purpose:To analyze the recovery course of foveal microstructures and evaluate the important structures for visual improvement after vitrectomy for full thickness macular hole (MH) using optical coherence tomography (OCT). Methods: We retrospectively reviewed the medical records of 34 cases with idiopathic macular hole. We investigated the healing process of foveal microstructures and visual acuity pre-and post-operatively at 1, 3, 6, 12 months after surgery. We evaluated the integrity of four factors by OCT image: existence of MH (Hole, H1,3,6,12), recovery of outer nuclear layer (ONL, O1,3,6,12), recovery of external limiting membrane (ELM, E1,3,6,12), and recovery of inner segment-outer segment (IS/OS) line of the photoreceptor (Photoreceptor, P1,3,6,12). We compared the recovery course and visual acuity of the four groups based on postoperative 12 months. Results: The mean observed period was 1.85 ± 2.59 months at recovery of ONL, 3.78 ± 3.83 months at recovery of ONL and ELM, and 7.40 ± 3.56 months at recovery of ONL, ELM and IS/OS line. At postoperative 12 months, the best corrected visual acuity (BCVA) of Groups E and P were better than that of Groups H and O (p < 0.05). Except for group H, all groups had improved BCVA at postoperative 12 months compared to preoperative BCVA (p < 0.05). Conclusions

show abstract

Internal Limiting Membrane Removal during Macular Hole Surgery

Cited by 165 publications

References 90 publications

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Macular Hole Closure With Internal Limiting Membrane Abrasion Technique

Recovery Course of Macular Structure after Macular Hole Surgery: Using a Spectral Domain Optical Coherence Tomography Image

Contact Info

Product

Resources

About