Indocyanine Green Reduces the Viability of Human Lens Epithelial Cells and Promotes Cytolysis: An Ex Vivo Study

PURPOSE: To investigate the effects of indocyanine green (ICG) solution on the viability and cytolysis of human lens epithelial cells ex vivo. METHODS: A total of 200 pieces of anterior capsules were obtained during cataract surgery, and 110 pieces of the anterior capsules were randomly divided into five groups and treated by immersion in different concentrations of ICG solution. The remaining 90 anterior capsules were also divided into five groups and treated with a combination of drug immersion and washing in balanced salt solution. Electron microscopy and trypan blue and eosin stains were used to analyze the cells. Percentage of dead, shedding, or living lens epithelial cells was estimated and used to demonstrate effects of the ICG on viability and cytolysis. RESULTS: Compared with the control group, the percentage of dead and shedding lens epithelial cells increased while the percentage of living lens epithelial cells decreased in all the immersion groups. In the washing groups, the percentage of the living lens epithelial cells was 63.42% ± 2.49%, 54.04% ± 1.84%, 43.51% ± 2.63%, 29.21% ± 2.40%, and 15.73% ± 1.61% for the five groups and reflected a concentration–effect relationship. Electron microscopy showed that the higher the concentration of the ICG solution, the more severe the destruction of the lens epithelial cell structure. CONCLUSIONS: ICG could reduce the viability of the lens epithelial cells and promote cell cytolysis. TRANSLATIONAL RELEVANCE: Our study showed that ICG could directly reduce the viability of the lens epithelial cells in a concentration-dependent fashion, which can theoretically reduce the incidence of posterior capsule opacification.