Purpose
Brilliant Blue G (BBG) is a safe and effective dye used to highlight the internal limiting membrane during macular surgery. A recent outbreak of BBG associated Fusarium spp. endophthalmitis raises concerns about this off-label, non- FDA approved intraocular use. We propose that the utilization of a 0.22 μm filter intraoperatively can reduce the risk of inoculating an eye with contaminated BBG.
Methods
An in vitro model of contaminated BBG was prepared. Laboratory stock cultures of 7 organisms including Staphyloccocus epidermidis, Streptococcus pneumoniae, Staphyloccocus aureus, Haemophilus influenza, Klebsiella pneumoniae, Fusarium spp., and Candida albicans were prepared in five 10-fold dilutions and injected into BBG vials. These mixtures were drawn with either a 5 μm filter, 0.22 μm, or without a filter and cultured on appropriate plates and growth conditions.
Results
No culture plates that had inoculate drawn through a 0.22 μm filter showed evidence of growth. There was evidence of growth for all organisms when no filter was used. A 5 μm was insufficient to filter Fusarium spp.
Conclusions
Using a 0.22 μm filter in the intraoperative processing of BBG would likely reduce the risk of infectious endophthalmitis resulting from contaminated dye.
Keywords: 762 vitreoretinal surgery •
467 clinical laboratory testing