title: Prospective study of surgical outcomes and bleb morphology using indocyanine green as a surgical dye in trabeculectomy with mitomycin C.
abstract: BACKGROUND
  To investigate the effect of adding indocyanine green to mitomycin C in augmented trabeculectomy.
  
  
  METHODS
  A prospective, non-comparative interventional case series.
  
  
  METHODS
  A total of 37 eyes of 37 patients followed up for 1 year.
  
  
  METHODS
  A solution containing 12.5 mg/mL of indocyanine green was added to mitomycin C, resulting in an mitomycin C concentration of 0.2-0.4 mg/mL, which was applied to bare sclera and Tenon's capsule for 3 min during trabeculectomy.
  
  
  METHODS
  Visual acuity, intraocular pressure, bleb morphology, Moorfields Bleb Grading System scores and complications.
  
  
  RESULTS
  Indocyanine green could be visualized on clinical examination for all eyes on the first postoperative day. Mean intraocular pressure decreased from 22.9 ± 6.2 mmHg to 12.1 ± 4.4 mmHg postoperatively (P < 0.001) at 1 year. Thirty-four eyes (91.9%) achieved an intraocular pressure of less than 21 mmHg at final visit without additional topical intraocular pressure-lowering medications. Three eyes (8.1%) developed bleb failure and required Baerveldt device implantation. There were no cases of blebitis or late bleb leak. No adverse effects attributable to indocyanine green could be identified postoperatively.
  
  
  CONCLUSIONS
  The addition of indocyanine green during trabeculectomy improves the visibility of antimetabolites intraoperatively and allows for the estimation of antimetabolite treatment area intraoperatively and postoperatively. It appears to have no adverse effect on surgical outcomes and complication rates, while improving safety of antimetabolite use.
authors.affiliation: Eye Department, Wellington Hospital, Wellington, New Zealand.
authors.forename: Kenneth C Y
authors.initials: KC
authors.lastname: Chan
authors.forename: Ghee S
authors.initials: GS
authors.lastname: Ang
authors.forename: Wayne
authors.initials: W
authors.lastname: Birchall
authors.forename: Tracey
authors.initials: T
authors.lastname: Wong
authors.forename: Laura
authors.initials: L
authors.lastname: Wakely
authors.forename: Graham M B
authors.initials: GM
authors.lastname: Reeves
authors.forename: Keith M
authors.initials: KM
authors.lastname: Small
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Wells
mesh_terms: D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage; D004396:Coloring Agents; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000473:pathology*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007208:Indocyanine Green; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies; D012590:Sclera / Q000187:drug effects; D019738:Surgically-Created Structures / Q000473:pathology*; D058475:Tenon Capsule / Q000187:drug effects; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D004396:Coloring Agents; D016685:Mitomycin; D007208:Indocyanine Green