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Uludağ Üniversitesi, Tıp Fakültesi Göz Hastalıkları Anabilim Dalı Purpose : Surgically removal of retinal internal limiting membrane (ILM) is quite difficult because of the poor visibility. In this study, we evaluate the efficiency of the use of ICG dye in identification and removal of ILM in macular surgery.
Methods : Of the consecutive 20 patients who were studied; 8 were idiopathic macular hole, 12 were long standing diffuse or cystoid macular edema secondary to diabetic retinopathy, retinal vein occlusion, cataract surgery or uveitis. After pars plana vitrectomy and removal of the posterior hyaloid, total fluid-air exchange has been injected into the vitreous cavity. Following a waiting period of 1.5 minute, ICG solution has been removed and the vitreous cavity filled up vith fluid again. Finally the green stained ILM in the macular area has been peeled using ILM forceps.
Results : In all cases, It has been observed that the ILM gets homogeneously stained in green in the macular area. The peeling procedure could easily be performed steadily at an intended diameter as the ICG staining increased the visibility of the ILM and the retina underneath was not stained. There-fore, a clear contrast has been observed between the non-stained underneath retina and the stained ILM around. In 4 cases, a minimal retinal hemorrhage has occured. In all cases, histopathological study confirmed that the removed membranes are ILM.
Conclusion: ICG solution of 0.25% clearly stains the ILM which was previously not visible and this technique facilitates the removal of ILM in all of our cases. Keywords : Macular surgery, Indocyanine green staining, Internal limitine membrane peeling