Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?

Purpose: To evaluate functional and anatomical outcome of triamcinolone acetonide assisted internal limiting membrane (ILM) peeling in patients with macular hole. Methods: Fifteen eyes of 15 consecutive patients were identified with stage 3 and 4 idiopathic macular holes, these undergoing triamcinolone acetonide assisted ILM peeling for macular holes. These were matched retrospectively with 15 eyes of 15 patients with stage 3 and 4 idiopathic macular holes of less than six months duration, who underwent macular hole surgery with ILM peel augmented with indocyanine green (ICG). Functional and anatomical outcomes were compared between two groups. Results: There were no significant differences between the two groups with reference to demographic features of age, sex, staging of the macular holes and the proportion subsequently undergoing cataract surgery. The mean follow-up period was 6.4 months in the triamcinolone acetonide group and 7.2 months in the ICG group. The hole closure rate was 100% in both group at primary operation. The mean Snellen line change was +1.24 in the intravitreal triamcinolone group and +1.1 in the ICG group. There was a significant improvement in Snellen and Logmar visual acuity in both groups. These differences in visual outcome between the groups were not statistically significant. Conclusions: Our data showed similar outcomes for patients with macular hole where ICG has been used when compared to patients where triamcinolone acetonide has been used for ILM peeling. Further study with longer follow-up and large series is warranted to assess the safety of the triamcinolone acetonide assisted ILM peeling in macular hole surgery.