Epiretinal membrane surgery assisted by trypan blue

Perrier, Manuel; Sébag, Mikaël

doi:10.1016/s0002-9394(02)02256-0

Cited by 56 publications

(25 citation statements)

References 6 publications

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“…20,28 Osmolality and pH of the Trypan blue solution Trypan blue has been used for ERM peeling and ILM peeling in concentrations varying from 0.06 to 0.2%. 5,6,[8][9][10][11][29][30][31] None of these concentrations were reported as toxic in clinical practice. Haritoglou et al 5 found visions 6 months after ERM removal to be similar between eyes operated with and without Trypan blue.…”

Section: Discussionmentioning

confidence: 99%

Use of heavy Trypan blue in macular hole surgery

Oberstein

Smet

2010

Eye

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Purpose Intraocular dyes facilitate the identification of the inner limiting membrane (ILM) during surgery. Appropriate dyes should be safe, provide adequate staining, and be easy to use. Heavy Trypan blue eliminates the need for an air-fluid exchange (AFX) and appears to have little retinal toxicity. This study refers to a prospective, consecutive trial with heavy Trypan blue in macular hole surgery. Patients and methods A consecutive group of 20 patients with full thickness macular holes was recruited in a single institution study. Patients were operated using conventional methods. Heavy Trypan blue was prepared by mixing isovolumetrically glucose 10% with MembraneBlue (DORC, Zuidland, The Netherlands). Patients were assessed for ease of surgery and post-operatively at 3 and 6 months (vision and ocular coherence tomography) for hole closure and vision. Results Twenty eyes were included in the study. Reapplication of dye was used in 75% of the cases, leading to improved contrast further facilitating the ILM peel. In no case was an AFX necessary to obtain sufficient staining. Macular hole closure was achieved in 19 of 20 patients with one surgery. No retinal detachment or other complication was observed in the follow-up period. Conclusion Heavy Trypan blue can be delivered efficiently to the retinal surface without the need for an AFX. Staining was sufficient to help visualise and peel the ILM. Repeat applications were easily performed. The macular hole closure rate was similar to that of other series with a comparable visual improvement.

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Section: Discussionmentioning

confidence: 99%

Use of heavy Trypan blue in macular hole surgery

Oberstein

Smet

2010

Eye

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“…Trypan blue had been used for staining of the anterior capsule in cataract surgery for over a decade before. 29 It displays outstanding staining of ERMs, 30,31 while evidence on its affinity to the ILM is controversial. 13,30,32,33 Trypan blue is generally recommended for the removal of epiretinal tissue rather than for ILM peeling itself, 34 although several clinical studies suggest that TB may be more useful for ILM removal than customarily conceived.…”

Section: Discussionmentioning

confidence: 99%

“…13,30,32,33 Trypan blue is generally recommended for the removal of epiretinal tissue rather than for ILM peeling itself, 34 although several clinical studies suggest that TB may be more useful for ILM removal than customarily conceived. [31][32][33][35][36][37] Retinal toxicity has been occasionally reported from in vitro experiments 38 and in vivo studies, 39,40 while other authors found no indications for in vivo toxicity. 16,37,[41][42][43] The presence of ERM overlying the ILM requires a sequential approach.…”

Section: Discussionmentioning

confidence: 99%

Quantification of Contrast Recognizability in Sequential Epiretinal Membrane Removal and Internal Limiting Membrane Peeling in Trypan Blue–assisted Macular Surgery

Henrich

Priglinger

Haritoglou

et al. 2013

Retina

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Purpose: To evaluate the selectivity and strength of intraoperative trypan blue staining during removal of epiretinal membranes (ERMs) and the internal limiting membrane.Methods: Based on intraoperative videos, 51 consecutive chromovitrectomies in 51 patients with macular holes, macular pucker, vitreomacular traction syndromes, or persistent macular edema were retrospectively studied. Fifteen subjects underwent trypan blue, 14 indocyanine green, and 22 brilliant blue G chromovitrectomy. The main outcome measure was the color contrast between stained internal limiting membrane or ERM and the underlying unstained tissue by means of objective, quantitative, semiautomated chromaticity difference measurements.Results: Trypan blue stains both ERM and the internal limiting membrane (average chromaticity scores 8.51 and 7.09, respectively; P = 0.48). Internal limiting membrane chromaticity scores were similar for trypan blue (7.09) and brilliant blue G (6.81; P = 0.71) but clearly higher for indocyanine green (15.81; P = 2.45 · 10 −5 ).Conclusion: Under the premises of our study, trypan blue stains both ERM and the internal limiting membrane. Trypan blue's staining capacity of the internal limiting membrane is similar to that of brilliant blue G but significantly inferior compared with indocyanine green. Trypan blue, thus, represents a useful vital dye for chromovitrectomy, particularly in the presence of ERM, where it allows a sequential approach.

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“…In vitro and animal studies showed that trypan blue 0.06% has no toxic effects on the retina [23, 24]. Trypan blue has been used to stain the epiretinal membrane during vitrectomy in patients with proliferative vitreoretinopathy [25, 26]. …”

Section: Introductionmentioning

confidence: 99%

Double Visualization Using Triamcinolone Acetonide and Trypan Blue during Stage 3 Macular Hole Surgery

Yamamoto

Ozaki²,

Murakami³

2004

Ophthalmologica

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Purpose: To study the usefulness of intravitreal injection of triamcinolone acetonide and trypan blue for facilitating visualization and dissection of the posterior vitreous cortex and internal limiting membrane (ILM) during vitrectomy in idiopathic stage 3 macular holes. Methods: Pars plana vitrectomy was performed in 10 eyes of 10 patientswith idiopathic stage 3 macular holes. After core vitrectomy had been performed, triamcinolone acetonide was injected over the posterior pole. After separation of the visualized posterior vitreous cortex, trypan blue was injected over the macular area. Excised specimens were examined by electron microscopy. Results: Upon injection of triamcinolone acetonide, the posterior vitreous cortex and residual vitreous cortex could be visualized in all patients. The posterior vitreous cortex and residual vitreous cortex were completely removed. The ILM of the retina was stained faint blue and was successfully removed in all patients. Electron microscopy revealed that the triamcinolone-acetonide-visualized layer and the trypan-blue-stained layer had different histological features. No complications related to the use of triamcinolone acetonide and trypan blue were encountered. Conclusion: Double visualization of the posterior vitreous cortex and ILM using triamcinolone acetonide and trypan blue during vitrectomy may facilitate separation of the posterior vitreous cortex from the retina and removal of the ILM around the macular hole in patients withidiopathic stage 3 macular holes.

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Epiretinal membrane surgery assisted by trypan blue

Cited by 56 publications

References 6 publications

Use of heavy Trypan blue in macular hole surgery

Use of heavy Trypan blue in macular hole surgery

Quantification of Contrast Recognizability in Sequential Epiretinal Membrane Removal and Internal Limiting Membrane Peeling in Trypan Blue–assisted Macular Surgery

Double Visualization Using Triamcinolone Acetonide and Trypan Blue during Stage 3 Macular Hole Surgery

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