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KMID : 1813520220110020117
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Journal of the Korean Glaucoma Society
2022 Volume.11 No. 2 p.117 ~ p.122
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Direct Visualization of the Aqueous Outflow Pathway Using Indocyanine Green during Trabecular Microbypass Stent Implantation
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Kim Moo-Hyun
Lim Su-Ho
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Abstract
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Purpose : We describe a novel use of intracameral Indocyanine green (ICG) to confirm aqueous outflow to collector channels and aqueous veins after trabecular microbypass Schlemm’s canal stent insertion (iStent inject® W; Glaukos Corporation, Laguna Hills, CA, USA).
Case summary : We report three cases of glaucoma patients who underwent trabecular microbypass stent to observe aqueous outflow into episcleral veins using intracameral ICG dye injection. 0.5% ICG dye was injected intraoperatively into the anterior chamber near the stents. Automated irrigation or manual injection of balanced salt solution was used to pressurize the eye after ICG injection. We confirmed the episcleral and intrascleral vein engorgement and aqueous egression with ICG in two of the three cases. Although one case did not demonstrate the ICG egression into episcleral vein, episcleral vein engorgement was observed immediately.
Conclusions : To the best of our knowledge, this is first report using ICG dye to identify the aqueous outflow, especially trabeculocanalicular outflow during trabecular microbyapss stenting. Intracameral ICG dye injection might be safe and effective to identify aqueous outflow and Schlemm’s canal stent patency during trabecular microbypass stents implantation.
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KEYWORD
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Aqueous outflow, Glaucoma surgery, Indocyanine green, iStent inject, Trabecular microbypass stent
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