Purpose: To evaluate the contribution of intravitreal infracyanine green to macular hole and epimacular membrane surgery.
Patients And Methods: Twenty-five consecutive patients were operated on for macular hole (seven cases) or epiretinal membrane (18 cases) using intravitreal infracyanine. In most cases, 25mg of infracyanine powder was diluted in 5ml of solvent, then in 5ml of BSS and used within 1 hour. The solution was injected at the end of the vitrectomy and aspirated after 1-2 minutes. The internal limiting membrane was removed in both diseases. All specimens were studied using confocal microscopy or an immunocytochemical preparation.
Results: In cases of macular hole, the internal limiting membrane was bright green colored. Opening and peeling were greatly facilitated. In cases of epiretinal membrane, staining was variable: the most frequent aspect was an uncolored central area similar to a geographic map surrounded by a green stained zone. Sometimes the coloration appeared as sparse spots on the posterior pole. Occasionally the staining was homogeneous as in the macular hole cases. After the removal of the membrane, a second injection made it possible to check for the persistence of the internal limiting membrane and proceed to its ablation when necessary. A good correlation was found between surgical and histopathological aspects.
Conclusion: Intravitreal infracyanine green is very helpful for the removal of internal limiting membrane in macular holes and epiretinal membrane surgery.
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