Cytotoxicity of Indocyanine Green on Retinal Pigment Epithelium

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Abstract
RECENTLY, SEVERAL investigators have reported that peeling of the internal limiting membrane (ILM) to eliminate tangential traction force improves the anatomic closure rate and functional outcomes, 1-4 although other investigators hold a different opinion.5-7 However, if ILM removal is attempted during macular hole surgery, its visualization may be difficult. The staining of the ILM with indocyanine green (ICG) to enhance its visibility has recently been proposed.8-12 The procedure involves direct application of ICG to the inner surface of the retina in the macular area. No adverse effects of ICG were reported in these studies. The concentration of ICG used in these reports ranged from 0.6 to 5 mg/mL, and ICG was left in the vitreous cavity from 30 seconds to 5 minutes.