Abstract:AIM: To compared the therapeutic effect of improved macular hole surgery to traditional macular hole surgery for idiopathic macular hole(IMH).
METHODS: From April 2014 to June 2017, 28 eyes of 28 IMH patients who were treated in our hospital were selected consecutively and received surgical treatment independently performed by the same physician in our hospital. The patients were divided into A(traditional group)and B(improvement group)groups. All 13 cases in Group A were treated with traditional vitrectomy internal limiting membrane peeling and C3F8 tamponade, while all 15 cases in Group B were treated with improved indocyanine green-assisted internal limiting membrane peeling combined with macular hole reconstruction and air tamponade. All patients were reviewed at 1wk, 1, 3, and 6mo after surgery. The best corrected visual acuity(BCVA)before and after the operation, operation time, closure rate of the macular hole during the last review and prone time were compared between the two groups of patients.
RESULTS: There was no significant difference in closure rate between the two groups(P>0.05). Postoperative BCVA increased in both groups compared with preoperatively and the differences were statistically significant(P<0.05). But there was no significant difference on BCVA between the two groups both preoperatively and postoperatively(P>0.05). The operation time in Group B was significantly shorter than that in Group A(P<0.05). Prone time in Group B was significantly shorter than that in Group A, the difference was statistically significant(P<0.05).
CONCLUSION: This study shows that compared with the traditional group, the improved indocyanine green-assisted peeling of internal limiting membrane combined with macular hole reconstruction and air tamponade can achieve similarly high closure rates while the operation procedure was simplified and the operation time was shortened. Reduced number of instruments into and out of the incision can reduce the incidence of complications. The postoperative patient's prone time is significantly shortened, with high comfort and good compliance.
