Visual Outcomes of Macular Hole Surgery. | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2016]

Author(s):

1. Hussain Ahmad Khaqan: Department of Ophthalmology, Lahore General Hospital/PGMI, Lahore, Pakistan

2. Farrukh Jameel: Department of Ophthalmology, Lahore General Hospital/PGMI, Lahore, Pakistan

3. Muhammad: Department of Ophthalmology, Lahore General Hospital/ PGMI, Lahore, Pakistan

Abstract:

Objective: To determine the mean visual improvement after internal limiting membrane (ILM) peeling assisted with brilliant blue staining of ILM in macular hole, and stratify the mean visual improvement in different stages of macular hole. Study Design: Quasi-experimental study. Place and Duration of Study: Eye outpatient department (OPD), Lahore General Hospital, Lahore from October 2013 to December 2014. Methodology: Patients with macular hole underwent measurement of best corrected visual acuity (BCVA) and fundus examination with indirect slit lamp biomicroscopy before surgery. The diagnosis of all patients was confirmed on optical coherence tomography. All patients had 23G trans-conjunctival three ports pars plana vitrectomy, ILM peeling, and endotamponade of SF6. The mean visual improvement of different stages of macular hole was noted. Paired t-test was applied. Results: There were 30 patients, 15 males and 15 females (50%). The mean age was 62 ±10.95 years. They presented with low mean preoperative visual acuity (VA) of 0.96 ±0.11 logMar. The mean postoperative VA was 0.63 ±0.24 logMar. The mean visual increase was 0.33 ±0.22 logMar (p < 0.001). In patients with stage 2 macular hole, mean visual increase was 0.35 ±0.20 logMar (p < 0.001). In patients with stage 3 macular hole, mean visual increase was 0.44 ±0.21 logMar (p < 0.001), and in patients with stage 4 macular hole it was 0.13 ± 0.1 logMar (p = 0.004). Conclusion: ILM peeling assisted with brilliant blue is a promising surgery for those patients who have decreased vision due to macular hole, in 2 - 4 stages of macular hole.

Page(s): 839-842

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 26, Issue: 10, Year: 2016

Keywords:

Keywords are not available for this article.

References:

[1] McCannelCA,EnsmingerJL,DiehlNN,HodgeDN, 2009.Population based incidence of macular holes,Ophthalmol 116 1366 -9

[2] ChristensenUC, 2009.Value of internal limiting membrane peeling in surgery for idiopathic macular hole,Acta Ophthalmol 87 1 -23

[3] Grandofer, 2009.Pathology of the macular hole rim in flat mounted internal limiting membranes specimens,Retina 29 1097 -105

[4] ChaudhryNA,ShaheerM., 2014.Comparison of brilliant blue G and trypan blue in macular hole surgery,Pak J Ophthalmol 30 4 -

[5] FarahME,MaiaM,RodriguesE., 2009.Dyes in ocular surgery: Principles for use in chemovitrectomy,Am J Ophthalmol 148 332 -40

[6] MachidaS,TobaY,NishimuraT,OhzekiT,MuraiK,KurosakaD., 2014.Comparisons of cone electrograms after indocyanin green, brilliant blue G, or triamcinolone assisted macular hole surgery,Greafe Arch Clin Exp Ophthalmol 252 1423 -33

[7] BabaT,HagiwaraA,SatoE,AraiM,OshitariT,YamamotoS., 2012.Comparison of vitrectomy with indocyanin green or brilliant blue G on retinal microvasculature and function of eyes in macular pathology,Ophthalmology 119 2609 -15

[8] IezziR,KapoorKG, 2013.No face down positioning and broad internal limiting membrane peeling in the surgical repair of idiopathic macular holes,Ophthalmology 120 1998 -2003

[9] Stanescu-SegallD,JacksonTL, 2009.Vital staining with indocyanine green: A review of the clinical and experimental studies relating to safety,Eye (Lond) 23 504 -18

[10] RodriguesEB, 2008.Meta-analysis of chromovitrectomy with indocyanine green in macular hole surgery,Ophthalmol 222 123 -9

[11] KhokharAR,FaizurRabbK,AkhtarHU, 2003.Outcome of macular hole surgery,J Coll Physicians Surg Pak 13 569 -72

[12] NadeemAhmed, 2012.Outcome of macular hole surgery at Mayo Hospital, Lahore,Pak J Ophthalmol 28 2 -

[13] SanisogluH,SevimMS,AktasB,SevimS,NohutcuA, 2011.Outcome of 23-gauge pars plana vitrectomy and internal limiting membrane peeling with brilliant blue in macular hole,Clin Ophthalmol 1177 -83

[14] YoshidaM,KishiS., 2007.Pathogenesis of macular hole recurrence and its prevention by internal limiting membrane peeling,Retina 27 169 -73

[15] ShuklaD,KelliathJ,NeelakantanN,NareshK,RamasameyK., 2011.A comparison of brilliant blue G, trypan blue and indocyanin green dyes to assist internal limiting membrane peeling during macular hole surgery,Retina 31 2021 -5

[16] KumagaiK,FurukawaM,OginoN., 2004.Vitreous surgery with and without internal limiting membrane peeling for macular hole repair,Retina 24 721 -7

[17] Al-AbdullaNA,ThompsonJT,SjaardaRN, 2004.Results of macular hole surgery with and without epiretinal dissection or internal limiting membrane removal,Ophthalmology 111 142 -9

[18] Da MataAP,BurkSE,RiemannCD, 2001.Indocyanine green assisted peeling of the retinal internal limiting membrane during vitrectomy surgery for macular hole repair,Ophthalmology 108 1187 -11

[19] ShuklaD,KelliathJ,PatwardhanA,KannanNB,ThayyilSB, 2012.A preliminary study of heavy brilliant blue G for internal limiting membrane staining in vitreoretinal surgery,Indian J Ophthalmol 60 531 -4

[20] AwaadD,SchraderI,BartokM,MohrA,GabelD., 2011.Comparitive toxicology of brilliant blue, trypan blue and their combination together with polyethylene glycol on human pigment epithelial cells,Inv Sci Visual Ophthalmol 52 4085 -90

Citations

Downloads

Views