May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Ultrastructural Changes of the Internal Limiting Membrane Removed During Conventional versus Indocyanine Green Assisted Peeling Surgery for Idiopathic Epiretinal Membrane
Author Affiliations & Notes
  • L. Konstantinidis
    Jules Gonin University Eye Hospital, LAUSANNE, Switzerland
  • S. Uffer
    Jules Gonin University Eye Hospital, LAUSANNE, Switzerland
  • E. Bovey
    Jules Gonin University Eye Hospital, LAUSANNE, Switzerland
  • Footnotes
    Commercial Relationships  L. Konstantinidis, None; S. Uffer, None; E. Bovey, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4703. doi:https://doi.org/
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      L. Konstantinidis, S. Uffer, E. Bovey; Ultrastructural Changes of the Internal Limiting Membrane Removed During Conventional versus Indocyanine Green Assisted Peeling Surgery for Idiopathic Epiretinal Membrane. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4703. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the histological features of cellular retinal fragments on the internal limiting membrane (ILM) removed during epiretinal membrane peeling surgery with and without the aid of ICG diluted in 5% glucose

Methods: : ILM specimens removed from 88 eyes undergoing vitrectomy and membrane peeling surgery for idiopathic epiretinal membrane between 1995 and 2003 were reviewed retrospectively. Surgery was performed in all cases by the same surgeon using the same technique. ICG was diluted with 5% glucose. Histological analysis focused on the presence and characteristics of retinal structures on the retinal surface of the ILM. Statistical analysis compared the results between group I (conventional surgery without ICG) and group II (ICG-assisted peeling)

Results: : Seventy-one eyes underwent EMM surgery without the aid of ICG (group I) and seventeen underwent EMM ICG-assisted surgery assisted using ICG (group II). The amount of Muller cell debris on the retinal surface of the ILM was more significant in the group I (no ICG) than in the group II (ICG) (40.8 versus 11.8; p = 0.024). Large fragments of Muller cells were more frequently observed in the group I (no ICG) than in the group II (ICG) (63.4% versus 23.5%; p= 0.003).The presence of larger retinal elements such as neural axons and vessels were observed attached to retinal face of the ILM in 5 (7%) cases of the no-ICG group. No such retinal elements were detected in any of the histological ILM specimens of the ICG-assisted group

Conclusions: : The use of ICG diluted with 5% glucose in the aid of ILM removal during epiretinal membrane surgery was associated with less retinal debris attached to retinal face of the ILM compared to surgery in which ICG was not used. Our findings contradict previous reports in the literature, in which use of ICG diluted with balanced salt solution (BSS) was associated with more retinal fragments attached to the retinal face of the ILM. According to our results, we hypothesize that diluting ICG with 5% glucose may decrease the adhesion of the ILM to the underlying retinal layers such that less retinal debris is removed with peeling of the ILM

Keywords: vitreoretinal surgery • pathology: human • Muller cells 
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