Chromovitrectomy: Update

Al-Halafi, Ali M

doi:10.1016/j.sjopt.2013.10.004

Cited by 16 publications

(11 citation statements)

References 85 publications

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“…These type of substances, such as indocyanine green (ICG), tryplan blue (TB), brilliant blue (BB) and other commercially available dyes, are used to enhance tissue visualization (e.g., internal limiting membrane, epiretinal membrane and vitreous) during vitreoretinal surgery, in what has been known as chromovitrectomy [51–53]. However, after tissue staining, they may interact with light sources and induce photosensitizing effects at the retinal surface by an overlap of the emission spectrum of the light source and the absorption band of the vital dye used during the vitrectomy procedure.…”

Section: Endoilluminationmentioning

confidence: 99%

Vitreoretinal instruments: vitrectomy cutters, endoillumination and wide-angle viewing systems

Oliveira¹,

Berger

Chow

2016

Int J Retin Vitr

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There have been many advances in vitreoretinal surgery since Machemer introduced the concept of pars plana vitrectomy, in 1971. Of particular interest are the changes in the vitrectomy cutters, their fluidics interaction, the wide-angle viewing systems and the evolution of endoillumination through the past decade and notably in the last few years. The indications of 27-gauge surgery have expanded, including more complex cases. Cut rates of up to 16,000 cuts per minute are already available. New probe designs and pump technology have allowed duty cycle performances of near 100% and improved flow control. The smaller vitrectomy diameter can be positioned between narrow spaces, allowing membrane dissection and serving as a multifunctional instrument. Enhanced endoillumination safety can be achieved by changing the light source, adding light filters, increasing the working distance and understanding the potential interactions between light and vital dyes commonly used to stain the retina. Wide-angle viewing systems (contact, non-contact or a combination of both) provide a panoramic view of the retina. Non-contact systems are assistant-independent, while contact systems may be associated with better image resolution. This review will cover some current aspects on vitrectomy procedures, mainly assessing vitrectomy cutters, as well as the importance of endoillumination and the use of wide-angle viewing systems.Electronic supplementary materialThe online version of this article (doi:10.1186/s40942-016-0052-9) contains supplementary material, which is available to authorized users.

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Section: Endoilluminationmentioning

confidence: 99%

Vitreoretinal instruments: vitrectomy cutters, endoillumination and wide-angle viewing systems

Oliveira¹,

Berger

Chow

2016

Int J Retin Vitr

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“…The most commonly used dyes are indocyanine green (ICG), infracyanine green (IfCG), trypan blue, brilliant blue, and triamcinolone acetonide. Following dye injection, the ILM is grasped directly with forceps or a flap of the ILM is created and vitreoretinal forceps are used to grasp the flap ( Figure 1 , [ 5 ]). Pulling with the forceps in a circular motion parallel to the retinal surface, the ILM flap is extended, peeled from the retinal surface, and removed.…”

Section: Techniquementioning

confidence: 99%

Retinal Damage Induced by Internal Limiting Membrane Removal

Gelman

Stevenson

Ponce

et al. 2015

Journal of Ophthalmology

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The internal limiting membrane (ILM), the basement membrane of the Müller cells, serves as the interface between the vitreous body and the retinal nerve fiber layer. It has a fundamental role in the development, structure, and function of the retina, although it also is a pathologic component in the various vitreoretinal disorders, most notably in macular holes. It was not until understanding of the evolution of idiopathic macular holes and the advent of idiopathic macular hole surgery that the idea of adjuvant ILM peeling in the treatment of tractional maculopathies was explored. Today intentional ILM peeling is a commonly applied surgical technique among vitreoretinal surgeons as it has been found to increase the rate of successful macular hole closure and improve surgical outcomes in other vitreoretinal diseases. Though ILM peeling has refined surgery for tractional maculopathies, like all surgical procedures it is not immune to perioperative risk. The essential role of the ILM to the integrity of the retina and risk of trauma to retinal tissue spurs suspicion with regard to its routine removal. Several authors have investigated the retinal damage induced by ILM peeling and these complications have been manifested across many different diagnostic studies.

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“…Improper visualization of different vitreoretinal tissue layers can lead to incomplete vitreous removal, iatrogenic breaks, long surgical time, and gliosis 1 . Various methods of staining vitreoretinal tissues, particularly the Internal Limiting Membrane (ILM) and Epiretinal Membrane (ERM), have been described [1][2][3] to aid visualization of ILM and ERM. Chromovitrectomy is the use of chemicals to stain semi-transparent preretinal structures as an aid in successful vitreoretinal surgery.…”

Section: Introductionmentioning

confidence: 99%

“…This study aimed to assess intraoperative advantages of modification T in staining technique of single injection of dual membrane blue (BBG dye) in the early stage of Pars Plana Vitrectomy (PPV) rather than standard late injection after complete vitrectomy, and this modification allows staining of all transparent tissues within vitreous cavity. Brilliant Blue G (BBG) stain was used in this study due to its efficacy, safety and affinity for both ILM and ERM 1,2 .…”

Section: Introductionmentioning

confidence: 99%

A Modified Staining Strategy in Stain-Assisted Vitrectomy

Al-Laftah¹

2018

Basrah Journal of Surgery

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The objective of this study is to assess pros and cons of intraoperative Briliant Blue G dye (BBG) injection in the early phase of Pars Plana Vitrectomy. This is a prospective non-consecutive case series study, a modification in timing for dye injection during vitrectomy. A single injection of 0.1 ml of Briliant Blue G (BBG dye) was used in the early phase of pars plana vitrectomy (PPV) promptly after an initial small core vitrectomy, and continued directly in completing vitrectomy; including induction of posterior vitreous detachment and peripheral vitrectomy +/-vitreous base shaving. View of the underlying retina is initially obscured immediately after dye injection, however dye density fade gradually with continuation of vitrectomy. Fluid Turbulence caused by vitrectomy and continuous fluid infusion enhance dye dissemination within vitreous cavity and stain transparent tissues and also increase colour contrast between blue hued retina and underlying naturally red coloured choroid. Early staining technique will remove necessity for Air-Fluid Exchange for staining at end of vitrectomy. This study was conducted in the Ophthalmology department at Hamad General Hospital in Doha, Qatar in 2016 and General Port Hospital in Basrah, Iraq in 2017. Patients requiring vitrectomy for various indications were included. Thirty four eyes (34 patients) were involved in this study: 20 men and 14 women, average age 56 was years. Indications for surgery were variable, diabetic vitrectomy (20 cases, 5/16= Macular Epiretinal Membrane), Rhegmatogenous Retinal Detachment (10 cases), Full Thickness Macular hole (2 case), Penetrating Injury with Posterior IOFB (2 cases). Single case required additional re-injection of dye to augment staining. Non-diathermy drainage Retinotomy was done by soft tipped cannula in 5 cases of retinal detachment. No single case has developed a surgically significant discolouration of lens posterior capsule or seepage of dye to the subretinal space. In conclusion, this modified staining technique allows better visualization of the various vitreoretinal tissues during all steps of PPV and improve surgical techniques.

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Chromovitrectomy: Update

Cited by 16 publications

References 85 publications

Vitreoretinal instruments: vitrectomy cutters, endoillumination and wide-angle viewing systems

Vitreoretinal instruments: vitrectomy cutters, endoillumination and wide-angle viewing systems

Retinal Damage Induced by Internal Limiting Membrane Removal

A Modified Staining Strategy in Stain-Assisted Vitrectomy

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