Resultados de la cirugía del agujero macular con diferentes técnicas de tratamiento

espanolObjetivo: Comparar la efectividad, eficiencia y complicaciones de las tres tecnicas quirurgicas empleadas en el tratamiento del agujero macular en el periodo 1998-2004 en nuestro centro. Metodos: Estudio retrospectivo, comparativo, intervencionista y no aleatorizado de 131 ojos con agujero macular idiopatico en estadio III y IV, operados con tres tecnicas. En 25 ojos se realizo vitrectomia simple (grupo 1), en 19 ojos se asocio rexis de la membrana limitante interna (MLI) (grupo 2), y en 87 ojos esta rexis se llevo a cabo previa tincion con verde de indocianina (ICG) (grupo 3). Las concentraciones de ICG empleadas fueron del 5%, 2,5% y 0,5%. Se compararon la recuperacion anatomica y funcional y las complicaciones en los distintos grupos. Resultados: El 88,4% (114 ojos) lograron la resolucion anatomica, siendo superior en el grupo 3 (90,6%). La recuperacion funcional se consiguio en el 63,6%. En ambos casos no existieron diferencias entre grupos. Las complicaciones mas importantes fueron: cataratas post-cirugia (51,9%), aumento de PIO (37,2%), desprendimientos de retina (7,8%) y alteraciones del epitelio pigmentario (7%). Esta ultima se relaciono con el uso de ICG (p EnglishPurpose: To compare the effectiveness, efficiency and complications of three different surgical techniques employed for the treatment of macular holes between 1998 -2004 in our health care centre. Methods: A retrospective, comparative, and non-randomized study of 131 eyes with macular holes, stage III and IV, treated with three different surgical techniques was performed. Vitrectomy was performed in 25 eyes (group 1). Vitrectomy was associated with internal limiting membrane peeling in 19 eyes (group 2), and in the remaining 87 eyes, the peeling of the retinal internal limiting membrane was assisted with indocyanine green (ICG) (group 3). The concentrations of ICG used were 5%, 2.5% and 0.5%. We compared the anatomic and functional results, and the complications which occurred. Results: The overall anatomic success rate was 88.4% (114 eyes), and it was higher in group 3 (90.6%). A visual acuity improvement was achieved in 63.6% of eyes; however there were no significant differences between the groups studied. The most important complications included cataracts (51.9%), increase in intra-ocular pressure (37.2%), retinal detachment (7.8%) and retinal pigment epithelial changes (7%). These pigment epithelial changes were associated with the use of ICG-assisted peeling (p