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Updated: Jun 12, 2026
The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
Published on: January 31, 2025
Safety testing of indocyanine green with different surgical light sources and the protective effect of optical
Jost Hillenkamp1, Sofia Dydykina, Alexa Klettner
1Department of Ophthalmology, University Medical Center Schleswig-Holstein, Kiel, Germany. hillenka@hotmail.com
Purpose:
The purpose of this study was to assess the light-induced cytotoxicity of indocyanine green (ICG) using different light sources commonly used in macular surgery and to assess the effect of optical filters.
Methods:
Primary cultures of porcine retinal pigment epithelium cells were incubated with 0.5 mg/mL ICG solution dissolved in 5% glucose and illuminated with a surgical light fiber for 3 or 15 minutes. Halogen, mercury vapor, xenon, and metal halide light sources were used. Cell viability was assessed using the MTT assay. Retinal pigment epithelium cells without illumination served as controls. The decomposition of ICG after illumination was analyzed by high-performance liquid chromatography.
Results:
Illumination of retinal pigment epithelium cells with all light sources with or without previous incubation with ICG did not affect cell viability compared with controls. Cell viability was significantly reduced when the cells were not rinsed immediately after incubation. The cytotoxic effect was abolished by a 475-nm long-pass filter. The high-performance liquid chromatography analysis of the illuminated ICG solution identified six cytotoxic ICG decomposition products.
Conclusion:
Optical filters that narrow the emission spectrum of the light sources reduce the light-induced cytotoxicity of ICG. Optical filters applied in ICG-assisted macular surgery may reduce the risk of intraoperative cell damage.
