This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (24)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Articles for Residents  • Ocular Imaging  • Alert me on articles by topic

Masayuki Horiguchi, MD; Shima Nagata, MD; Naoki Yamamoto, PhD; Yoshihisa Kojima, MD; Yoshiaki Shimada, MD

Arch Ophthalmol. 2003;121:327-331.

Objective  To determine the elimination kinetics of indocyanine green (ICG) after intraocular operations using ICG staining.

Methods  Intraocular fluorescence of ICG was determined using the ICG angiographic mode of a scanning laser ophthalmoscope (in vivo) and fluorescence microscopy (in vitro) after circular curvilinear capsulorhexis with ICG staining during cataract surgery and internal limiting membrane (ILM) peeling with ICG staining during macular hole surgery.

Subjects  We studied 9 eyes of 7 patients with white cataracts and 14 eyes of 14 patients with idiopathic macular holes.

Results  Scanning laser ophthalmoscopy revealed fluorescence in the anterior segment of patients with cataracts on the first postoperative day, and fluorescence remained for a mean ± SD of 6.0 ± 2.2 days postoperatively. Scanning laser ophthalmoscopy also revealed fluorescence in the posterior pole of patients with macular holes, and it remained for a mean ± SD of 2.7 ± 1.4 months postoperatively. Fluorescence microscopy showed fluorescence of the entire tissues, suggesting that ICG had stained not only the surface of the membranes but had also entered them. In both operations, visual outcomes were not significantly different from the results obtained without ICG.

Conclusions  Because entire tissues were stained, the differences in ICG kinetics might also be caused by factors other than differences in stainability, such as the environment surrounding the tissues or molecular structural differences between the lens capsule and the ILM. Although we found complete disappearance of fluorescence and good functional recovery, the longer resident time of the dye after macular hole surgery may suggest a potential risk to intraocular tissues.

From the Department of Ophthalmology (Drs Horiguchi, Nagata, Kojima, and Shimada) and the Joint Research Laboratory (Dr Yamamoto), Fujita Health University School of Medicine, Toyoake, Japan.
The authors have no relevant financial interest in this article.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Retinal tolerance to dyes
Luke et al.
Br. J. Ophthalmol. 2005;89:1188-1191.
ABSTRACT | FULL TEXT  

Chemical Toxicity of Indocyanine Green Damages Retinal Pigment Epithelium
Ikagawa et al.
IOVS 2005;46:2531-2539.
ABSTRACT | FULL TEXT  

A comparison of outcomes after indocyanine green and trypan blue assisted internal limiting membrane peeling during macular hole surgery
Lee et al.
Br. J. Ophthalmol. 2005;89:420-424.
ABSTRACT | FULL TEXT  

Triamcinolone-Assisted Internal Limiting Membrane Peeling During Idiopathic Macular Hole Surgery
Horio et al.
Arch Ophthalmol 2005;123:96-99.
FULL TEXT  

Safety Testing of Indocyanine Green and Trypan Blue Using Retinal Pigment Epithelium and Glial Cell Cultures
Jackson et al.
IOVS 2004;45:2778-2785.
ABSTRACT | FULL TEXT  

Effect on Visual Outcome After Macular Hole Surgery When Staining the Internal Limiting Membrane With Indocyanine Green Dye
Horio and Horiguchi
Arch Ophthalmol 2004;122:992-996.
ABSTRACT | FULL TEXT  

Reduction of Indocyanine Green-Associated Photosensitizing Toxicity in Retinal Pigment Epithelium by Sodium Elimination
Ho et al.
Arch Ophthalmol 2004;122:871-878.
ABSTRACT | FULL TEXT  

Toxic Effects of Intravitreal Indocyanine Green on Neuroretinal Cells
Rodrigues et al.
Arch Ophthalmol 2004;122:663-663.
FULL TEXT