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S.Y. Lesnik–Oberstein, S.H. Tan, M.D. de Smet; Clinical Use of Heavy Membrane Blue . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4210.
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By using dyes it is easier to identify the extent of an epiretinal membrane (ERM) or the inner limiting membrane (ILM) during surgery. Indocyanine green stains both ERM and ILM intensely, however there are worries about potential phototoxic and cytotoxic effects of this dye. Trypan blue also stains ERM and ILM but more weakly. The main drawback of the trypan blue for vitreoretinal surgery is that a fluid–air exchange is required before injecting the dye as it otherwise diffuses though the vitreous cavity and does not stain membranes sufficiently. To avoid the need for a fluid–air exchange we have proposed a modified form of trypan blue, which is rendered more dense than water by combining it with glucose. This abstract refers to a prospective, consecutive trial with membrane blue in vitreoretinal surgery.
2 groups of patients were identified prospectively. 1) epiretinal membranes (20 patients) 2) macular holes (20 patients).
Patients were operated using conventional methods. Heavy trypan blue was prepared by mixing glucose 10% with membrane blue (DORC, NL). Both ease of surgery and surgical results (vision, OCT) were assessed.
Peeling was facilitated as compared to cases in which no dye was used. Reapplication of dye was necessary in half of the cases, leading to improved contrast further facilitating the peeling process. In no case was a fluid air exchange necessary to obtain sufficient staining. Vision in both groups was similar.
The mixture of trypan blue with 10% glucose facilitates its use during surgery. By eliminating the need for a fluid air exchange, repeat application of the dye can easily be carried out. This leads to a more complete removal of the membrane without having a negative effect on vision.
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