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K. H. Park, J. H. Kim, Y. S. Yu, J. M. Hwang, H. Chung; Intraoperative Extraocular Indocyanin Green (IE-ICG) Dye Test as a New Method to Detect Peeled Internal Limiting Membrane. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4136.
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To evaluate efficacy of intraoperative, extraocular ICG dye staining test (IE-ICG) as a new method for differentiating peeled ILM from thin epiretinal membrane.
We performed ILM peeling in patients with idiopathic macular hole (MH, n=10) or diabetic macular edema (DME, n=10) without intraocular ICG dye staining or with assistance of intravitreal triamcinolone acetonide. We also did membrane peeling in patient with idiopathic epiretinal membrane (ERM, n=10) without staining of vital dye. Then, the membrane was stained with ICG (1.25mg/ml) in the outside operation field and examined under the surgical microscope and light microscope. After the examination, the membrane is fixed to glutaladehyde and perform electron microscope to confirm whether it is ILM or thin epiretinal membrane.
Concordance rate is 100% between results of IE-ICG dye test and those of electron microscopic examinantion of the membranes. However, concordance rates between surgeon’s intraoperative impression of membrane and IE-ICG is 100% in MH, 80% in DME, and 50% ERM, respectively. Surgeon’s impression of membrane is somewhat inaccurate especially in patients with idiopathic epiretinal membrane.
Considering the cost, difficulty of tissue preparation, and time consuming process of histologic confirmation of ILM, intraoperative, extraocular indocyanin green dye test can be a useful alternatives to differentiate peeled ILM from thin epiretinal membrane.
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