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CA Gass, C Haritoglou, M Schaumberger, A Kampik; Functional results after Indocyanine Green-assisted vitrectomy for idiopathic macular pucker . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2485.
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Purpose: To describe functional results after Indocyanine Green (ICG) assisted pars plana vitrectomy for idiopathic macular pucker and to compare the results to the outcome without the intraoperative use of ICG. Methods: 43 patients with idiopathic macular pucker were prospectively analyzed. All patients were seen one day preoperatively and 1,3 and 6 months postoperatively (or longer). During all visits a clinical examination including visual acuity and Goldmann perimetry was performed. Surgery consisted of standard pars plana vitrectomy. Intraoperatively, epiretinal membranes were removed using an end-gripping forceps. Additionally the internal limiting membrane (ILM) was peeled off. In 16 patients the ILM was stained using BSS plus diluted ICG (concentration <0.5%, 275 mOsm, pH 7.5) (group1). In 27 patients no dye such as ICG was used (group 2).The results were then compared using SPSS for windows. Results: Preoperative visual acuity was 20/80 (median, range 20/125 - 20/32) in group 1 and 20/80 (median, range 20/400 - 20/32) in group 2. Postoperatively visual acuity increased to 20/64 (median, range 20/250 - 20/25, p≷0.5) in group 1 and to 20/40 (median, range 20/200 - 20/25, p<0.001). Mean follow-up time was 5 months in both groups. While a homogeneous increase in visual acuity (gain in lines 0-9) was observed in group 2, some patients of group 1 experienced a remarkable decrease of up to 4 lines. We observed 2 retinal detachments and three cases of postoperative visual field defects in group1. Conclusion: Our findings suggest a possible retinal damage after the application of ICG in surgery for macular pucker. Whether this is due to the substance itself, more intensive peeling of the stained and therefore better visible ILM or other mechanisms is subject of further investigation. As a consequence the use of ICG has been discontinued in our institution. None.
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