Indocyanine green staining and removal of internal limiting membrane in macular hole surgery: histology and outcome☆
Section snippets
Methods
Commercially available indocyanine green preparation for fundus angiography was used (DiagnogreenInjection; Daiichi Pharmaceutical, Tokyo, Japan). Twenty-five milligrams of indocyanine green in the vial were reconstituted with the 10-ml solution provided; 0.5 ml of this solution was further diluted with 4.5 ml of balanced salt solution (Alcon, Fort Worth, Texas) to make up to 5 ml. The final concentration was 0.25 mg/ml. The osmolarity of this preparation was 293 mOsm, as compared with 291 mOsm
Results
Ten consecutive patients (10 eyes) were prospectively recruited. Patient demographics, diagnosis, and outcomes were tabulated in Table 1. The mean follow-up period was 3.6 months (range, 3 to 5 months). Nine eyes were stage 3 or stage 4 macular hole cases; four of them were chronic with more than 1-year duration. The tenth eye had a staphylomatous macular detachment secondary to a myopic macular hole. Intraoperatively, visible epiretinal membrane was only observed and removed in this eye. In
Discussion
In the present study, we have shown that indocyanine green staining followed by removal of internal limiting membrane was feasible in patients with macular hole with a favorable anatomical outcome. Similarly, Kadonosono and associates16 has recently reported an indocyanine green staining technique using a specially designed cannula with viscomaterial as a carrying medium. In their series of 13 patients with stage 3 or stage 4 macular holes, 92% attained anatomical closure. This is comparable to
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This work was supported in part by the Mr. YT Cheng Eye Foundation, Hong Kong.