Retinal pigment epithelial change after macular hole urgery with indocyanine green-aited internal limiting membrane peeling

PURPOE: To report the reult of macular hole urgery uing indocyanine green to improve viualization and facilitate peeling of the internal limiting membrane. METHOD: A retropective noncomparative review of a conecutive erie of 22 patient (22 eye) who underwent macular hole repair uing indocyanine green to facilitate viualization of the internal limiting membrane wa performed. One patient wa excluded becaue of a hitory of a rhegmatogenou retinal detachment. All patient underwent a three-port par plana vitrectomy with internal limiting membrane peeling. Indocyanine green (0.1% olution) wa ued to ait in the viualization of the internal limiting membrane. The main outcome meaure were potoperative viual acuity, macular hole tatu, and potoperative retinal pigment epithelial change. REULT: In 21 eye, the median preoperative bet-corrected viual acuity wa 20/200 (range, 20/60 to counting finger at 5 feet). The median potoperative viual acuity wa 20/400 (range, 20/60–1/200) with an average follow-up of 13 week. The macular hole wa cloed in 18 eye (86%) at the mot recent follow-up. Ten eye were found to have atrophic retinal pigment epithelium change in the area of the previou macular hole. CONCLUION: Indocyanine green ait in viualization of the internal limiting membrane in macular hole urgery. In our erie, 10 eye had unuual atrophic change in the retinal pigment epithelium at the ite of the previou macular hole, or in the area where the indocyanine green olution would have had direct acce to the bare retinal pigment epithelium cell. Although the ue of indocyanine green improve viualization and ait with peeling of the internal limiting membrane, the afety and potential toxicity of indocyanine green to the retinal pigment epithelium require further invetigation.