Use of Lutein and Zeaxanthin Alone or Combined with Brilliant or Trypan Blue to Identify Intraocular Structures Intraoperatively in Cadaveric Eyes

Abstract

Purpose: : To determine whether a natural dye solution based on Lutein and Zeaxanthin (L/Z) alone or combined with Brilliant or Trypan Blue (BB/TB) stains and facilitates peeling of intraocular membranes in human eyes.

Methods: : 80 cadaveric eyes undergone capsulorhexis followed by open-sky vitrectomy. L/Z concentrations (0.01%-20%) were tested alone or combined with different BB/TB concentrations (0.0095%-0.1%) in the corneal endothelium and epithelium, anterior and posterior capsule, vitreous cavity and internal limiting membrane. Dye solutions were in contact with intraocular membranes for less than 1 minute. Specimens were examined by light and electron transmission microscopy.

Results: : Contact between L/Z and L/Z+BB/TB and the retinal, lens, and vitreous surface resulted in orange and greenish staining of the intraocular membranes, which facilitated surgical steps in all eyes. L/Z alone was useful for vitreous identification, L/Z combined with BB had strong affinity for internal limiting membrane (ILM) and anterior capsule (AC) and L/Z combined with TB clearly identified the AC. Light microscopy confirmed ILM and AC removal in all eyes tested. No dye solutions remained in the eyes after the membrane removal.

Conclusions: : A natural dye solution based on L/Z alone or combined with BB/TB efficiently stained AC, vitreous and ILM in human cadaveric eyes and may be a useful tool for vitreoretinal and cataract surgery.

Keywords: vitreoretinal surgery • cataract