A new surgical approach for indocyanine green-assisted internal limiting membrane peeling

BACKGROUND AND OBJECTIVE: The efficiency of indocyanine green (ICG) dye in the removal of the internal limiting membrane (ILM) with a fluid needle using passive aspiration was evaluated. PATIENTS AND METHODS: Eighteen consecutive patients with diffuse diabetic macular edema were studied. After vitrectomy and total fluid-air exchange, 0.1 mL of ICG solution 0.25% was left in the macular area for 1 minute. Then the macular ILM was peeled with a specially designed tapered fluid needle using passive aspiration. RESULTS: In 16 of the 18 eyes, the peeling procedure could be easily performed with a tapered fluid needle using passive aspiration. In 11 eyes, partial development of spontaneous ILM detachment prior to the peeling process was also observed. CONCLUSIONS: ICG solution 0.25% appears to reduce the adhesive force of the ILM to the sensory retina, which makes the removal of the ILM much easier by passive aspiration with a fluid needle.