Abstract
PurposeThis study evaluated the color contrast ratio (CCR) of the internal limiting membrane (ILM) using different color settings of digitally assisted vitreoretinal surgery (DAVS) with different indocyanine green (ICG) concentrations.sMethodsThis is a prospective comparative observational study. Consecutive patients that underwent 25G vitrectomy and ILM peeling using a standard operating microscope (SOM) (25 eyes), DAVS Ver. 1.1 (12 eyes), or DAVS Ver. 1.3 (13 eyes) were enrolled. The SOM and DAVS Ver. 1.1 groups used 0.075% ICG, and the DAVS Ver. 1.3 group used 0.025% ICG. In DAVS Ver. 1.1, macular CCR was compared between four different presets in the red, green, and blue channels: Default (Red (R) 100%, Green (G) 100%, and Blue (B) 100%); Preset 1 (R 20%, G 100%, B 100%); Preset 2 (R 80%, G 80%, B 100%), and Preset 3 (R 85%, G 100%, B 90%). In DAVS Ver. 1.3, macular CCR was evaluated using two different customized settings that modified the hue and saturation: Customized Setting 1 (R 86, G 100, B 100%, Hue +2°, Saturation 90%, Gamma 1.2) and Customized Setting 2 (R 90, G 100, B 100%, Hue +20°, Saturation 100%, Gamma 0.9). All patients underwent ophthalmologic examinations including BCVA at baseline and at 12 months.ResultsIn DAVS Ver. 1.1, macular CCR was highest in Preset 3 (P < 0.01). The CCR of Customized Setting 2 of DAVS Ver. 1.3 using 0.025% ICG did not differ from that of Preset 3 in DAVS Ver. 1.1 using 0.075% ICG. Furthermore, there was no significant difference in BCVA between the Customized Setting 2 of DAVS Ver. 1.3 with 0.025% ICG and the Preset 3 of DAVS Ver. 1.1 with 0.075% ICG groups at baseline and at 12 months (P > 0.05, respectively).ConclusionCustomized DAVS settings enabled surgeons to use a 3-fold lower ICG concentration in ILM peeling.
Highlights
Since Ekardt et al [1] first reported internal limiting membrane (ILM) peeling in full-thickness macular hole (MH) surgery in 1997, this approach has been used routinely to improve MH closure rates [2, 3]
There was no significant difference in BCVA between the Customized Setting 2 of digitally assisted vitreoretinal surgery (DAVS) Ver. 1.3 with 0.025% indocyanine green (ICG) and the Preset 3 of DAVS Ver. 1.1 with 0.075% ICG groups at baseline and at 12 months (P > 0.05, respectively)
The present study evaluated the color contrast ratio (CCR) of images captured during vitrectomy using different DAVS color settings
Summary
Since Ekardt et al [1] first reported internal limiting membrane (ILM) peeling in full-thickness macular hole (MH) surgery in 1997, this approach has been used routinely to improve MH closure rates [2, 3]. According to the preference and trends (PAT) survey of the American Society of Retina Specialists (ASRS), more than 60% of vitreoretinal surgeons in the United States and Europe are performing ILM peeling during ERM surgery [5]. ASRS conducted a PAT survey to determine whether adjuvant dyes and which ones are used to aid in macular surgery. Several studies have reported potential toxic effects of the ICG [10,11,12] and BBG dyes [13,14,15] used during macular surgery. Protocols that minimize the use and amounts of these dyes would be clinically desirable
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