Ultrastructure of the vitreoretinal interface following the removal of the internal limiting membrane using indocyanine green

Abstract

Purpose: To investigate the morphological changes of the vitreoretinal interface following the removal of the internal limiting membrane (ILM) using indocyanine green (ICG).

Methods: In 10 primate eyes, a pars plana vitrectomy was performed followed by ICG-assisted peeling of the ILM. Morphological changes in the exposed inner surface of the retina were investigated by electronmicroscopy immediately, 3, 6 and 12 months after the ILM removal.

Results: The excised ILM was associated with fragments of glial tissue. The Muller cell processes were damaged and removed at the corresponding region of the retina. Regenerative spindle-shaped Muller cell processes were observed focally showing a meshwork like configuration at 3 and 6 months. Flattened and stretched processes were observed at 12 months; however, there was no apparent ILM regeneration.

Conclusions: ICG assisted ILM peeling was observed to cause mild damage to the vitreoretinal interface, which did not completely recover within 12 months.