Artikel
Comparative investigation in the toxicity of two different dyes used in epiretinal surgery: Indocyanine green (ICG) vs Trypan blue (TB)
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
The introduction of ICG for staining the internal limiting membrane (ILM) has significantly facilitated epiretinal surgery. For about two years some authors have reported on visual field defects after ICG-assisted ILM-peeling. This investigation aims to compare the functional outcome after macular hole surgery using two different dyes for ILM-staining: 1. ICG and 2. TB.
Methods
Within a prospective study pars plana vitrectomy with ILM-removal and fluid-gas-exchange was performed in 30 eyes of 30 patients for macular hole (stage II - IV according to the classification of Gass). The ILM was stained before fluid-gas-exchange using ICG (15 eyes, group 1) or TB (15 eyes, group 2). The ophthalmological examination preoperatively and 6 weeks after surgery included the assessment of visual acuity (VA), treshold perimetry (Humphrey, 30°) and multifocal electroretinogram (Retiscan, 61 segments, 30°).
Results
Anatomical success was achieved in 13 eyes of group 1 (87%) and in 12 eyes of group 2 (80%). Mean VA improved from 0.16 to 0.32 (group 1) and from 0.18 to 0.36 (group 2). There was no significant difference between pre- and postoperative value of the mean b-amplitude/deg2 and no visual field defect was detected in both groups. ICG stained the ILM more intensive than TB did.
Conclusions
Using ICG or TB facilitates ILM-removal and seems to have no negative impact on functional results after macular hole surgery. TP only provides a gentle staining of the ILM which is why we prefer ICG.