ICG-assisted ILM peeling in high myopia shows promising outcomes

Peeling the internal limiting membrane with dye assistance seems to give equally good results in macular hole surgery in highly myopic eyes as in emmetropic eyes, a study showed.

Alvin K.H. Kwok, MD, and T.Y.Y. Lai of the Hong Kong Eye Hospital prospectively recruited 10 patients with severe myopia – defined as –6 D or greater – who had macular holes without retinal detachment. One eye of each patient received indocyanine green (ICG)-assisted removal of the ILM for 3 to 4 disc diameters around the macular hole. These eyes were matched with 10 emmetropic eyes with macular hole that underwent the same procedure.

The mean refractive error in the myopic eyes was –11.8 D. The control eyes had a mean error of +0.3 D. Mean follow-up in the eyes with myopia was 12 months and in the control group, 13 months.

Both groups had primary anatomical closure rates of 90%. Both groups of eyes showed a significant improvement in visual acuity postoperatively.

The mean preop and postop visual acuity, rates of final visual acuity of 20/50 or better and improvement of two of more lines were not statistically different between the two groups.

The study is published in the July issue of British Journal of Ophthalmology.