Retinal Consequences after ICG Staining of the ILM during Macular Hole Surgery
Jesse I., Hermans P., Lommatzsch A., Pauleikhoff D.
Dep. of Ophthalmology, St. Franziskus Hospital, Münster, Germany
Purpose: Clinical studies demonstrated an accumulation of ICG in the retinal axons with transport towards the optic disc after staining of the ILM during macular hole surgery. The present study investigated if these changes are due to direct accumulation of ICG in these structures during the staining procedure and if morphological changes are associated.
Method: In 20 pat. with macular holes stage 3 a vitrectomy with standarized ICG staining (0.3 ml of 1:10 ICG solution under air) was performed with consecutive ILM peeling and final air-gas exchange. To distinguish between a direct immediate diffusion of ICG into the retinal axons and a secondary diffusion of ICG from the remaining stained ILM in 10 pat. a small (<2PD) excision of the ILM and in 10 a large (>4PD) excision was performed. In all patients preoperative, 2, 4, 8 and 12 weeks after the surgery an ophtalmoscopical examination, ICG pictures, VEP and central visual fields were undertaken. In addition ILM fragments stained with ICG were investigated electronmicroscopically and the morphological findings were compared with unstained ILM morphology.
Results: In all patients independent of the size of the ILM excision 2 weeks after surgery staining of the retinal axons at the area of the temporal arcades, at the optic disc and at the macular hole was visible. During the follow up visits at 4 and 8 weeks
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