PURPOSE: To demonstrate the advantages and efficacy of internal limiting membrane removal under perfluorocarbon liquid in macular,hole,associated retinal detachment. DESIGN: Interventional case series. METHODS: Four patients with macular-hole-associated retinal detachment underwent pars plana vitrectomy, retinal reattachment with endodrainage through the mac, ular hole, perfluoro-n-octane injection to seal the macular hole, indocyanine green injection under the perfluoro-n-octane bubble and removal of the indocyanine green-stained internal limiting membrane. Visual acuity and anatomic results were recorded, with a mean follow,up period of 18 months. RESULTS: Postoperatively, the retina was reattached in all four patients and closure of the macular hole was achieved in three eyes. Visual acuity improved in all eyes. CONCLUSION: In retinal detachment resulting from mac, ular hole, staining of the internal limiting membrane with indocyanine green injected under perfluoro-n-octane can facilitate peeling of the membrane without exertion of excessive retinal traction and may prevent passage of indocyanine green into the subretinal space. (C) 2003 by Elsevier Inc. All rights reserved.