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Clinical evaluation of the use of indocyanine green for peeling the internal limiting membrane in macular hole surgery

  • Clinical Investigation
  • Published:
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Abstract

Background

To evaluate the role of indocyanine green (infracyanine) in macular hole surgery.

Methods

A retrospective review of 38 consecutive eyes with macular hole, operated on with internal limiting membrane peeling (ILM), using or not using infracyanine (ICG), diluted in glucose 5% and filtered. Anatomical and functional results were analysed in each group, using visual field testing, fluorescein fundus angiography and particularly blue filter fundus photographs for the detection of retinal pigment epithelial changes and lesions of optic nerve fibres layer.

Results

Fifteen eyes underwent surgery without ICG and 23 eyes with ICG. The mean period of follow-up was 10 months. The duration of surgery was significantly lower in the group with ICG than without (P<0.001). Overall, 84% of the holes closed without difference between both groups. The improvement in vision at 1, 6 and 12 months was similar in both groups. Fewer defects in the optic nerve fibres layer were observed in the group with ICG than without (P=0.02). Staining with ICG revealed the presence of an associated epiretinal membrane in 61% of eyes, whereas it was clinically visible in only 17.5% before surgery.

Conclusion

Using ICG for ILM peeling produced similar visual results to those obtained without ICG. It reduced significantly the duration of surgery and the trauma to the optic nerve fibres layer, without increasing the risk of retinal pigment epithelial damage. However, in the light of recent reports about the possible toxicity of ICG, its use should be restricted in clinical practice to difficult cases.

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Fig. 1
Fig. 2

Abbreviations

ICG:

Indocyanine green

ILM:

Internal limiting membrane

ETDRS:

Early treatment diabetic retinopathy study

VA:

Visual acuity

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Authors and Affiliations

  1. Centre Hospitalier National d'Ophtalmologie des Quinze-vingts, 28 rue de Charenton, 75012, Paris, France

    Aude Husson-Danan

  2. Clinique Ophtalmologique Universitaire de Créteil, Hôpital Intercommunal et Hôpital Henri Mondor (Assistance Publique-Hôpitaux de Paris), Université Paris XII, 40, Avenue de verdun, 9400, Créteil, France

    Agnès Glacet-Bernard, Gisèle Soubrane & Gabriel Coscas

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  1. Aude Husson-Danan
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  2. Agnès Glacet-Bernard
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  3. Gisèle Soubrane
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  4. Gabriel Coscas
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Correspondence to Aude Husson-Danan.

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Husson-Danan, A., Glacet-Bernard, A., Soubrane, G. et al. Clinical evaluation of the use of indocyanine green for peeling the internal limiting membrane in macular hole surgery. Graefe's Arch Clin Exp Ophthalmo 244, 291–297 (2006). https://doi.org/10.1007/s00417-005-0046-z

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  • DOI: https://doi.org/10.1007/s00417-005-0046-z

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