Indocyanine green-assisted ILM peeling in macular hole surgery revisited.

PURPOSE: To report visual outcomes after peeling of the internal limiting membrane (ILM) using a brief application of low dose indocyanine green (ICG) for macular hole repair. DESIGN: Prospective, nonrandomized interventional case series. METHODS: A consecutive series of 16 eyes of 14 patients with full-thickness macular hole underwent vitrectomy and peeling of the ILM with an intravitreal application of 0.05% ICG for less than 10 seconds. RESULTS: The ILM could be removed uneventfully in 5 of 16 cases after a single ICG application and in 11 cases after a second ICG application. The macular hole was closed in 15 (93.7%) of 16 cases after a single surgery and in one case after a repeat surgery, as evaluated by optical coherence tomography. A significant visual acuity improvement was achieved as the mean logarithm of the minimum angle of resolution was from 0.600 preoperatively (equivalent to approximately 5/20 in the conventional 20 foot numerator form) to 0.213 (12/20) at the end of follow-up (P < .0001). None of the cases developed peripheral visual field defect. Ophthalmoscopies or optic coherence tomographic images did not reveal any disruption at the level of the retinal pigment epithelium. CONCLUSIONS: A brief intravitreal application of low dose ICG may provide a safe ILM peeling in vitreomacular surgeries.

Anatomic and visual outcomes after indocyanine green-assisted peeling of the retinal internal limiting membrane in idiopathic macular hole surgery.

PURPOSE: To report anatomic and visual outcomes after vitrectomy and adjunctive retinal internal limiting membrane (ILM) peeling with and without intravitreal indocyanine green for idiopathic macular hole repair. DESIGN: Retrospective comparative study of consecutive case series. METHODS: Three consecutive groups of idiopathic macular hole cases underwent modifications of surgical technique. Group I (48 eyes of 47 patients) underwent a standard vitrectomy, fluid/gas exchange, and 1 week's face-down positioning, group II (21 eyes of 21 patients) an adjunctive ILM peeling without use of indocyanine green, and group III (28 eyes of 28 patients) an adjunctive peeling of ILM stained with intravitreal application of 0.1 to 0.2 ml of 0.5% indocyanine green dye. RESULTS: Three groups of patients had comparable clinical characteristics as to age, gender, estimated duration of macular hole, preoperative visual acuity, and follow-up time. The rate of macular hole closure after a single surgery, as determined by optical coherence topography was 85.4% in group I, 85.7% in group II, and 100% in group III. Groups I and II showed a statistically significant visual improvement, but group III did not show significant visual acuity improvement as the mean logarithm of the minimal angle of resolution visual acuity was from 0.767 (20/120) preoperatively to 0.691 (20/100) postoperatively (P =.342). Eight cases in group III developed within a few postoperative months of optic disk pallor and irreversible peripheral visual field loss, predominantly affecting the nasal field. CONCLUSIONS: Intravitreal indocyanine green-assisted ILM peeling improves anatomic success in macular hole surgery, but it may potentially lead to unfavorable visual acuity outcome and peripheral visual field loss.

Crystal Structures and Luminescence Properties of Platinum(II) Complexes Containing 3,3'-Biisoquinoline.

Three new platinum complexes containing 3,3'-biisoquinoline (i-biq), [Pt(CN)(2)(i-biq)] (1), [PtCl(2)(i-biq)] (2), and [Pt(i-biq)(2)](PF(6))(2) (3), have been synthesized as orange-red, yellow, and colorless crystals, respectively. Their crystal structures and luminescence properties are reported. Crystal data: for 1.0.5H(2)O, PtO(0.5)N(4)C(20)H(13), orthorhombic, Pbcm, a = 13.989(2) Å, b = 18.304(1) Å, c = 6.682(3) Å, V = 1710.9(6) Å(3), Z = 4, and final R = 0.039 (R(w) = 0.033) for 970 independent reflections; for 2.DMF.H(2)O, PtCl(2)O(2)N(3)C(21)H(21), triclinic, P&onemacr;, a = 11.047(1) Å, b = 12.397(3) Å, c = 8.000(2) Å, alpha = 106.56(1) degrees, beta = 100.15(1) degrees, gamma = 76.15(1) degrees, V = 1012.8(3) Å(3), Z = 2, and final R = 0.058 (R(w) = 0.077) for 4219 independent reflections; for 3.2DMF, PtP(2)F(12)O(2)N(6)C(42)H(38), triclinic, P&onemacr;, a = 10.795(2) Å, b = 13.511(2) Å, c = 8.281(1) Å, alpha = 105.22(1) degrees, beta = 112.17(1) degrees, gamma = 85.02(1) degrees, V = 1079.2(3) Å(3), Z = 1, and final R = 0.038 (R(w) = 0.042) for 3606 independent reflections. Square-planar complexes of 1 are stacked in the crystal to form a columnar structure with the Pt-Pt distance of 3.34 Å. The crystal emits strongly, even at room temperature, and the emission spectrum is similar to that for the [Pt(CN)(2)(bpy)] crystal (bpy = 2,2'-bipyridine), which is due to a (3)dpi[dsigma(Pt) --> pi(i-biq)] transition. The single crystal emission spectrum at 77 K is, however, observed as a superposition of broad (3)dpi and sharp (3)pipi(i-biq) emissions. The crystal structure of 2 has a completely different stacking structure from that of 1. The stacking occurs on the i-biq ligands, and the Pt atoms are separated more than 6 Å. The complex exhibits only a structured emission component assigned to the (3)pipi(i-biq) transition in the crystal at 77 K, in agreement with the crystal structure with no Pt-Pt interaction. In the crystal of 3, the [Pt(i-biq)(2)](2+) complexes are stacked but offset, being in close contact between parts of adjacent i-biq ligands. There is no Pt-Pt interaction also in this case. Two i-biq ligands in the complex are distorted to adopt the bowed conformation due to the steric crowding of the alpha-hydrogens on opposite ligands. Nevertheless, 3 provides almost the same (3)pipi emission spectrum as 1 and 2 in dilute glassy solution at 77 K. The (3)pipi emission spectra observed in the crystals of these Pt(II) complexes are red-shifted compared with those in dilute glassy solution. The fact is attributable to the pi-pi intermolecular interactions between the ligands in the crystals. The factors controlling the crystal structures for these complexes are also discussed.