Altered uptake of infrared diode laser by retina after intravitreal indocyanine green dye and internal limiting membrane peeling.
OBJECTIVE
To report an altered uptake and possible complication associated with the use of indocyanine green (ICG) dye, internal limiting membrane (ILM) peeling, and infrared diode laser.


METHODS
Interventional case report.


METHODS
In two eyes (two patients) three-port pars plana vitrectomy was performed. Indocyanine green was injected into the vitreous cavity according to previously published protocol. The ILM was removed with a bent-tipped microvitreoretinal blade and ILM forceps. Photocoagulation was performed with an 810-nm infrared diode endolaser.


RESULTS
Photocoagulation of the retina stained with ICG in areas with intact ILM produced more intense and superficial appearing retinal burns than photocoagulation where the ILM had been peeled. The retinal burns in areas of intact ILM stained with ICG also appeared more superficial than those typical of this laser when ICG is not used.


CONCLUSIONS
Indocyanine green absorbs infrared laser light and produces a photothermal effect. Unwanted damage to the inner retinal layers may occur. Laser energy may also be prevented from reaching the deeper retinal layers, reducing the efficacy of treatment.
Department of Ophthalmology and Visual Sciences, Vitreoretinal Service, University of Texas Medical Branch at Galveston, Galveston, Texas 77555-1141, USA. Robert_Blem@hotmail.com
Robert I
RI
Blem
Paul D
PD
Huynh
Edmond H
EH
Thall
D001485:Basement Membrane / Q000601:surgery; D004396:Coloring Agents / Q000009:adverse effects*; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D007208:Indocyanine Green / Q000009:adverse effects*; D007259:Infrared Rays; D007431:Intraoperative Complications / Q000139:chemically induced*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000601:surgery*; D012167:Retinal Perforations / Q000601:surgery; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000601:surgery
D004396:Coloring Agents; D007208:Indocyanine Green