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Brilliant Blue-Assisted Peeling of The Internal Limiting Membrane In The Treatment of Macular Hole

Year 2010, Issue: 3, 140 - 144, 01.09.2010

Abstract

Brilliant blue-assisted peeling of the ınternal limiting membrane in the treatment of macular hole Purpose: To evaluate the anatomical and visual outcomes of brilliant blueassisted peeling of the internal limiting membrane ILM in patients with idiopathic macular hole IMH . Materials and Methods: The charts of 32 patients 32 eyes who had undergone PPV combined brilliant blue-assisted ILM peeling due to idiopathic macular hole were retrospectively reviewed. There were 10 men and 22 women, and the mean age of the patients was 64.4 years. In all patients, a complete ophthalmological examination including visual acuity determination, slit-lamp biomicroscopy, intraocular pressure IOP measurement, fundus examination, fundus fluorescein angiography FFA and optical coherence tomography OCT was performed before and after surgery. Results: Visual acuity averaged at 0.098 Snellen lines before surgery. The mean follow-up time was 9.2 months and vision acuity improved or unchanged in %93.7 of patients after surgery. The average improvement in visual acuity was 3.2 lines. The most common complication was cataract formation after surgery 59.0% . Postoperative rhegmatogenous retinal detachment was observed in two eyes 6.2% . After surgery, the rate of unclosed macular hole was 12.5%, and anatomically closed after reoperation. The rate of recurrence of macular hole was 3.1%. Conclusion: We observed that PPV combined with brilliant blue-assisted ILM peeling is a safe and effective procedure and increases the visual acuity.

References

  • Gass JDM.: Idiopathic senile macular hole: Its early stages and pathogenesis. Arch Ophthalmol. 1988;106:629-639.
  • Bainbridge J, Herbert E, Gregor Z.: Macular holes: vitreoretinal relationships and surgical approaches. Eye. 2008;22:1301-1309.
  • Sobacı G, Bayer A, Taş A.: İdiyopatik ve travmatik maküla deliklerinin vitrektomi ve iç limitan membran soyulması ile tedavisi: İlk sonuçlarımız. Ret- Vit. 2001;9:225-231.
  • Kelly N, Wendel R.: Vitreous surgery for idiopathic macular holes. Arch Ophthalmol. 1991;109:654-659.
  • Wendel RT, Patel AC, Kelly NE, et al.: Vitreous surgery for macular holes. Ophthalmology 1993;100:1671-1676.
  • Tornambe PE, Poliner LS, Grote K.: Macular hole surgery without face-down positining. A pilot study. Retina. 1997;17:179-185.
  • Ovalı T.: Makula deliğinin tedavisinde perfluoropropan gazı ve silikon yağı ile internal tamponadın karşılaştırılması. T Oft Gaz. 2001;31:631-637.
  • Christensen UC.: Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology. Acta Ophthalmol. 2009;2:1-23.
  • Yagi F, Sato Y, Takagi S, Tomita G.: Idiopathic macular hole vitrectomy without postoperative face-down positioning. Jpn J Ophthalmol. 2009;53:215-218.
  • Schaal S, Barr CC.: Management of macular holes: a comparison of 1-year outcomes of 3 surgical techniques. Retina. 2009;29:1091-6.
  • Avcı R.: Maküler cerrahide retinal iç limitan membranın indosiyanin yeşili ile boyanarak soyulması. Ret-Vit. 2002;10:32-37.
  • Schurmans A, Van Calster J, Stalmans P.: Macular hole surgery with inner limiting membrane peeling, endodrainage, and heavy silicone oil tamponade. Am J Ophthalmol. 2009;147:495-500.
  • Kumagai K, Furukawa M, Ogino N, Larson E.: Incidence and factors related to macular hole reopening. Am J Ophthalmol. 2010;149:127-32.
  • Gandorfer A, Haritoglou C, Gass CA, et al.: Indocyanine green-assisted peeling of the internal limiting membrane may cause retinal damage. Am J Ophthalmol. 2001;132:431–433.
  • Enaida H, Sakamoto T, Hisatomi T, et al.: Morphological and functional damage of the retina caused by intravitreous indocyanine green in rat eyes. Graefes Arch Clin Exp Ophthalmol. 2002;240:209–213.
  • Sippy BD, Engelbrecht NE, Hubbard GB, et al.: Indocyanine green effect on cultured human retinal pigment epithelial cells: implication for macular hole surgery. Am J Ophthalmol. 2001;132:433–435.
  • Haritoglou C, Gandorfer A, Gass CA, et al.: Indocyanine green-assisted peeling of the internal limiting membrane in macular hole surgery affects visual outcome: a clinicopathologic correlation. Am J Ophthalmol. 2002;134:836–841.
  • Uemura A, Kanda S, Sakamoto Y, Kita H. Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol. 2003;136:252–257.
  • Veckeneer M, van Overdam K, Monzer J, et al.: Ocular toxicity study of trypan blue injected into the vitreous cavity of rabbit eyes. Graefes Arch Clin Exp Ophthalmol. 2001;239:698–704.
  • Haritoglou C, Gandorfer A, Schaumberger M, et al.: Trypan blue in macular pucker surgery: an evaluation of histology and functional outcome. Retina. 2004;24:582–590.
  • Yam HF, Kwok AK, Chan KP, et al.: Effect of indocyanine green and illumination on gene expression in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci. 2003;44:370–377.
  • Rezai KA, Farrokh-Siar L, Gasyna EM, Ernest JT.: Trypan blue induces apoptosis in human retinal pigment epithelial cells. Am J Ophthalmol. 2004;138:492–495.
  • Hisatomi T, Enaida H, Matsumoto H, et al.: Staining ability and biocompatibility of brilliant blue G: preclinical study of brilliant blue G as an adjunct for capsular staining. Arch Ophthalmol. 2006;124:514-519.
  • Freeman W, Azen S, Kim J, et al.: Vitrectomy for the treatment of fullthickness stage 3 or 4 macular holes. Arch Opthalmol. 1997;115:11-21.
  • Willis A. Garcia-Cosio J.: Macular hole surgery. Ophthalmology. 1996;103:1811-1814.
  • Brooks HL Jr.: Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology. 2000:107:1939-1948.
  • Mester V, Kuhn F.: Internal limiting membrane removal in the management of full-thickness macular holes. Am J Ophthalmol. 2000:129:769-777.
  • Park DW, Sipperley JO, Sneed SR, et al.: Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology. 1999:106:1392-1397.
  • Enaida H, Ishibashi T.: Brilliant blue in vitreoretinal surgery. Dev Ophthalmol. 2008;42:115-125.
  • Nomoto H, Shiraga F, Yamaji H, et al.: Macular hole surgery with triamcinolone acetonide-assisted internal limiting membrane peeling: one-year results. Retina. 2008;28:427-32.
  • Kumagai K, Furukawa M, Ogino N, Larson E, Uemura A.: Long-term outcomes of macular hole surgery with triamcinolone acetonide-assisted internal limiting membrane peeling. Retina. 2007;27:1249-54.
  • Enaida H, Hisatomi T, Goto Y, et al.: Preclinical investigation of internal limiting membrane peeling and staining using intravitreal brilliant blue G. Retina. 2006;26:623– 630.
  • Isomae T, Sato Y, Shimada H.: Shortening the duration of prone positioning after macular hole surgery- comparison between 1-week and 1-day prone positioning. Jpn J Ophthalmol. 2002;46:84-88.

Makula Deliği Tedavisinde Brilliant Mavisi Yardımı ile İnternal Limitan Membran Soyulması

Year 2010, Issue: 3, 140 - 144, 01.09.2010

Abstract

Amaç: İdyopatik makula deliği İMD olan olgularda brilliant mavisi yardımı ile internal limitan membran ILM soyulmasının anatomik ve görsel sonuçlarının değerlendirilmesi. Metod: İdyopatik makula deliği nedeniyle PPV ile kombine brilliant mavisi yardımı ile ILM soyulması uygulanan 32 olgunun 32 gözüne ait veriler retrospektif olarak incelendi. Olguların 10’u erkek, 22’i bayan olup ortalama yaşları 64.4 yıl idi. Tüm olgularda cerrahi öncesi ve sonrası görme keskinliği, slit-lamp biomikroskopi, göz içi basıncı GİB ölçümü, fundus muayenesi, fundus floresein anjiografi FFA ve optik koherens tomografi OKT içeren tam bir oftalmolojik muayene yapıldı. Bulgular: Cerrahi öncesi ortalama görme keskinliği 0.098 Snellen sırası idi. Ortalama takip süresi 9.2 ay olup cerrahi sonrası görme artışı veya aynı görme keskinliği olguların %93.7’inde saptandı. Ortalama görme artışı 3.2 Snellen sırası olarak saptandı. Cerrahi sonrası en sık gözlenen komplikasyon katarakt gelişimi idi %59.0 . Postoperatif dönemde iki gözde %6.2 regmatojen retina dekolmanı gelişti. Ameliyat sonrası kapanmayan makula deliği oranı %12.5 olup tekrar cerrahi sonrası 2 olguda makula deliği kapandı. Nüks delik oranı ise %3.1 1 göz idi.Sonuç: ERM’lı olgularda, PPV ile birlikte brilliant mavisi ile ILM soyulmasının etkin ve güvenilir bir yöntem olduğunu, görme keskinliğini arttırdığını gözlemledik

References

  • Gass JDM.: Idiopathic senile macular hole: Its early stages and pathogenesis. Arch Ophthalmol. 1988;106:629-639.
  • Bainbridge J, Herbert E, Gregor Z.: Macular holes: vitreoretinal relationships and surgical approaches. Eye. 2008;22:1301-1309.
  • Sobacı G, Bayer A, Taş A.: İdiyopatik ve travmatik maküla deliklerinin vitrektomi ve iç limitan membran soyulması ile tedavisi: İlk sonuçlarımız. Ret- Vit. 2001;9:225-231.
  • Kelly N, Wendel R.: Vitreous surgery for idiopathic macular holes. Arch Ophthalmol. 1991;109:654-659.
  • Wendel RT, Patel AC, Kelly NE, et al.: Vitreous surgery for macular holes. Ophthalmology 1993;100:1671-1676.
  • Tornambe PE, Poliner LS, Grote K.: Macular hole surgery without face-down positining. A pilot study. Retina. 1997;17:179-185.
  • Ovalı T.: Makula deliğinin tedavisinde perfluoropropan gazı ve silikon yağı ile internal tamponadın karşılaştırılması. T Oft Gaz. 2001;31:631-637.
  • Christensen UC.: Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology. Acta Ophthalmol. 2009;2:1-23.
  • Yagi F, Sato Y, Takagi S, Tomita G.: Idiopathic macular hole vitrectomy without postoperative face-down positioning. Jpn J Ophthalmol. 2009;53:215-218.
  • Schaal S, Barr CC.: Management of macular holes: a comparison of 1-year outcomes of 3 surgical techniques. Retina. 2009;29:1091-6.
  • Avcı R.: Maküler cerrahide retinal iç limitan membranın indosiyanin yeşili ile boyanarak soyulması. Ret-Vit. 2002;10:32-37.
  • Schurmans A, Van Calster J, Stalmans P.: Macular hole surgery with inner limiting membrane peeling, endodrainage, and heavy silicone oil tamponade. Am J Ophthalmol. 2009;147:495-500.
  • Kumagai K, Furukawa M, Ogino N, Larson E.: Incidence and factors related to macular hole reopening. Am J Ophthalmol. 2010;149:127-32.
  • Gandorfer A, Haritoglou C, Gass CA, et al.: Indocyanine green-assisted peeling of the internal limiting membrane may cause retinal damage. Am J Ophthalmol. 2001;132:431–433.
  • Enaida H, Sakamoto T, Hisatomi T, et al.: Morphological and functional damage of the retina caused by intravitreous indocyanine green in rat eyes. Graefes Arch Clin Exp Ophthalmol. 2002;240:209–213.
  • Sippy BD, Engelbrecht NE, Hubbard GB, et al.: Indocyanine green effect on cultured human retinal pigment epithelial cells: implication for macular hole surgery. Am J Ophthalmol. 2001;132:433–435.
  • Haritoglou C, Gandorfer A, Gass CA, et al.: Indocyanine green-assisted peeling of the internal limiting membrane in macular hole surgery affects visual outcome: a clinicopathologic correlation. Am J Ophthalmol. 2002;134:836–841.
  • Uemura A, Kanda S, Sakamoto Y, Kita H. Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol. 2003;136:252–257.
  • Veckeneer M, van Overdam K, Monzer J, et al.: Ocular toxicity study of trypan blue injected into the vitreous cavity of rabbit eyes. Graefes Arch Clin Exp Ophthalmol. 2001;239:698–704.
  • Haritoglou C, Gandorfer A, Schaumberger M, et al.: Trypan blue in macular pucker surgery: an evaluation of histology and functional outcome. Retina. 2004;24:582–590.
  • Yam HF, Kwok AK, Chan KP, et al.: Effect of indocyanine green and illumination on gene expression in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci. 2003;44:370–377.
  • Rezai KA, Farrokh-Siar L, Gasyna EM, Ernest JT.: Trypan blue induces apoptosis in human retinal pigment epithelial cells. Am J Ophthalmol. 2004;138:492–495.
  • Hisatomi T, Enaida H, Matsumoto H, et al.: Staining ability and biocompatibility of brilliant blue G: preclinical study of brilliant blue G as an adjunct for capsular staining. Arch Ophthalmol. 2006;124:514-519.
  • Freeman W, Azen S, Kim J, et al.: Vitrectomy for the treatment of fullthickness stage 3 or 4 macular holes. Arch Opthalmol. 1997;115:11-21.
  • Willis A. Garcia-Cosio J.: Macular hole surgery. Ophthalmology. 1996;103:1811-1814.
  • Brooks HL Jr.: Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology. 2000:107:1939-1948.
  • Mester V, Kuhn F.: Internal limiting membrane removal in the management of full-thickness macular holes. Am J Ophthalmol. 2000:129:769-777.
  • Park DW, Sipperley JO, Sneed SR, et al.: Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology. 1999:106:1392-1397.
  • Enaida H, Ishibashi T.: Brilliant blue in vitreoretinal surgery. Dev Ophthalmol. 2008;42:115-125.
  • Nomoto H, Shiraga F, Yamaji H, et al.: Macular hole surgery with triamcinolone acetonide-assisted internal limiting membrane peeling: one-year results. Retina. 2008;28:427-32.
  • Kumagai K, Furukawa M, Ogino N, Larson E, Uemura A.: Long-term outcomes of macular hole surgery with triamcinolone acetonide-assisted internal limiting membrane peeling. Retina. 2007;27:1249-54.
  • Enaida H, Hisatomi T, Goto Y, et al.: Preclinical investigation of internal limiting membrane peeling and staining using intravitreal brilliant blue G. Retina. 2006;26:623– 630.
  • Isomae T, Sato Y, Shimada H.: Shortening the duration of prone positioning after macular hole surgery- comparison between 1-week and 1-day prone positioning. Jpn J Ophthalmol. 2002;46:84-88.
There are 33 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Abdullah Özkırış

Publication Date September 1, 2010
Published in Issue Year 2010Issue: 3

Cite

EndNote Özkırış A (September 1, 2010) Makula Deliği Tedavisinde Brilliant Mavisi Yardımı ile İnternal Limitan Membran Soyulması. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 3 140–144.