AIM: To evaluate the outcomes of indocyanine green compared with brilliant blue G used for internal limiting membrane(ILM)peeling in macular hole surgery.

METHODS: All studies about indocyanine green compared with brilliant blue G for assisting internal limiting membrane peeling during macular hole surgery all over the world were searched. PubMed, Ovid, ScineceDirect, NGC, EBSCO, EMBASE, CNKI, CBM were searched. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergence of opinion was settled by discussion or consulted by the expert. Meta-analysis was processed by Rev Man 5.3.

RESULTS: Seven trials on indocyanine green compared with brilliant blue G for assisting internal limiting membrane peeling during macular hole surgery involving 598 cases met the inclusion criteria in meta-analysis. The baseline of patients' characteristics were comparable in all studies. By comparing the three common criteria, including best corrected visual acuity(BCVA), macular hole closure rate and postoperative complications, we found that brilliant blue G was better than indocyanine green on improving best corrected visual acuity at 6mo postoperatively\〖Z=2.10(P=0.04), OR=0.10, 95% CI (0.01, 0.19)\〗. While there was no statistical difference between two groups on macular hole closure rate\〖Z=0.69(P=0.49), OR=0.95, 95% CI(0.82, 1.10)\〗. And there were no statistical differences in term of postoperative complications between two groups(P>0.05).

CONCLUSION: The available evidence indicates that the short-term recovery of best corrected visual acuity is significantly better in brilliant blue G(BBG)group than in indocyanine green(ICG)group, especially at 6mo after surgery. The long-term prognosis of BCVA which one study only reported need further study. There were no significant differences on macular hole closure rate and adverse events between two groups.The results indicate that BBG is preferable to ICG for use during macular hole surgery.