gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Comparative investigation in the toxicity of two different dyes used in epiretinal surgery: Indocyanine green (ICG) vs Trypan blue (TB)

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  • corresponding author P. Dillinger - Department of Ophthalmology, Bundeskappschaft's Hospital Sulzbach/Saar
  • U. Mester - Department of Ophthalmology, Bundeskappschaft's Hospital Sulzbach/Saar

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.01.16

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Dillinger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




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.


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°).


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.


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.