The Effect Of Inner Limiting Membrane Removal On Healing Of Idiopathic Macular Hole

Objective: To compare results of surgery for idiopathic macular hole (IMH) with and without inner limiting membrane (ILM) peeling. And to discuss the reliability and the effectiveness of using Triamcinolone acetonide (TA) during the surgery.Methods: Sixty-six eyes with IMHs underwent vitrectomy with or without ILM peeling. During the operation of ILM peeling, we ustd ICG or TA to help stain the ILM. Compare the closure rate, visual acuity, and complications for macular holes with and without ILM peeling. And compare the effect of TA and indocyanine green angiography (ICG) on the result of surgery.Results: Anatomic closure of the macular hole was achieved in 60 eyes, including 7 eyes without ILM peeling, 30 eyes with ILM peeling using ICG, and 23 eyes with ILM peeling using TA. Primary closure rate was significantly improved with ILM peeling (P<0.05). 6 months after the operation, visual acuity was improved in 7 eyes without ILM peeling. It was in 26 eyes with ILM peeling using ICG, and it was 21 eyes using TA. Thye mean visual acuity among the three groups had not statisticly significant different (P>0.05).Conclusions: ILM peeling significantly improves visual and anatomic success in IMHs, and it didn't increase the complications. During the victomy, using TA may help completely removing post vitreous cortex and successfully peeling ILM. There is no side effect of TA during the observation.