Removal of Retinal Indocyanine Green Dye by Autologous Serum Irrigation in Macular Hole Surgery

Abstract

Autologous serum irrigated in the vitreous cavity just before completion of macular hole surgery can help remove ICG dye used in surgery. The application was simple and safe and significantly shortened the period of residual retinal ICG staining.

The Effect of Autologous Serum on Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Hole

“…6,7 It has been reported that ICG can remain in the eye for several months, and infrared hyperfluorescence from ICG may persist for up to 36 months after ICG-assisted ILM peeling. 12,25 Consequently, the persistence of ICG may, in turn, cause prolonged adverse effects by promoting phototoxicity. 25 Possible solutions to minimize the adverse effects of ICG include brief intravitreal application of a small amount of ICG at a low concentration.…”

“…Nakamura et al also reported that autologous serum irrigation before completion of macular hole surgery could help remove residual ICG dye and reduce the persistence of dye, owning to ICG's high affinity and quick binding to lipoprotein in serum. 12 In our study, we sought to evaluate if intraoperative autologous serum could affect the anatomic and functional outcomes of ICG-assisted macular hole surgery. At the baseline, there was no significant difference between vitrectomy with serum and without serum groups in demographic characteristics, such as the percentage of females, mean age, mean refractive errors, mean axial length, mean preoperative VA, lens status, staging of macular hole, duration of symptoms, and follow-up time.…”

“…In addition, it may be difficult to completely remove the residual dye with serum, especially those that had entered the RPE cells, although serum can effectively remove free ICG dye over the retinal surface and shorten its period of residual retinal staining. 12 Since ICG toxicity on RPE may occur right after exposure to the dye, protection of the exposed RPE at the base of the macular hole may be an important issue, and other dyes with greater safety, such as brilliant blue G, may be a better choice. 24 In conclusion, ICG-assisted ILM peeling has anatomical and functional benefits for idiopathic full-thickness macular holes.…”

“…[9][10][11] It was also found to help remove ICG dye used in surgery, significantly shorten the period of residual retinal ICG staining, and probably reduce its toxicity. 12 Although autologous serum did not seem to enhance anatomic or visual results of macular hole surgery without ILM peeling, 1 there were few reports regarding the effect of autologous serum on ICGassisted ILM peeling for idiopathic macular holes. In this study, we sought to evaluate the effects, both with and without autologous serum, on ICG-assisted ILM peeling and compare the surgical outcomes using optical coherence tomography (OCT).…”

Aplicaciones del suero autólogo en oftalmología

“…-El suero autólogo ha sido también utilizado en clínica para la aplicación sobre puntos de fuga en ampollas de filtración (61), en el tratamiento de agujeros maculares de espesor completo, ya sea aplicado sobre el agujero macular o bien usado en el suero de irrigación para limpiar el verde de indocianina usado para visualizar la membrana limitante interna en la cirugía de agujero macular (62,63), desgarros retinianos (64), en asociación con concentrados de plaquetas se ha utilizado en modelos experimentales de cicatrización retiniana (65). -Nosotros estamos empleando suero autólogo en el manejo de la queratopatía cálcica como terapia de apoyo a los quelantes del calcio.…”