Indocyanine green-assisted peeling of the epiretinal membrane in proliferative vitreoretinopathy.
BACKGROUND
We stained the internal limiting membrane of patients suffering from proliferative vitreoretinopathy with indocyanine green solution during proliferative vitreoretinopathy surgery to improve the visibility of the membranes, and thereby histopathologically confirmed the excised epiretinal membranes.


METHODS
Three patients underwent a standard three-port pars plana vitrectomy with indocyanine green staining. After performing a subtotal vitrectomy we spread 0.5% indocyanine green solution, approximately 1 ml, on the retinal surface and peeled off the epiretinal membranes.


RESULTS
The epiretinal membranes did not stain clearly, while the internal limiting membranes did stain clearly. We could therefore distinguish the epiretinal membranes from the retina. We cut the internal limiting membrane, grasped it, and peeled off the internal limiting membrane underlying the epiretinal membranes using vitreoretinal forceps. A histopathologic examination confirmed the presence of proliferative cells and an extracellular matrix underlying the internal limiting membranes.


CONCLUSIONS
The technique for staining the epiretinal membranes in proliferative vitreoretinopathy using indocyanine green gives better visualization and allows surgeons to remove the epiretinal membranes more safely and effectively, as well as with less risk of retinal damage.
Sakamoto
Hidehisa
H
Department of Ophthalmology, Beppu National Hospital, Japan. hidehisa@med.kyushu-u.ac.jp
Yamanaka
Ichiro
I
Kubota
Toshiaki
T
Ishibashi
Tatsuro
T
D000368:Aged; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000150:complications / Q000473:pathology / Q000601:surgery*
D004396:Coloring Agents; D007208:Indocyanine Green