Abstract
Purpose: :
To determine whether natural dyes from the extract of ten different sources (pomegranate, haematoxylon campechianum, chlorophyll, cochineal, hibiscus, indigo, paprika, rosella, fustec wood and grape) stains and facilitates posterior hyaloid detachment and peeling of the retinal internal limiting membrane (ILM) in human eyes.
Methods: :
Open sky vitrectomy including removal of the posterior hyaloid and ILM was performed in 80 cadaveric eyes. Ten different dyes were injected into the posterior vitreous cavity to promote hyaloid detachment and after this procedure each specific dye was injected to perform the ILM removal. The dyes were allowed to settle on the macula for 5 minutes and were then removed by mechanical aspiration. Peeling of the ILM was initiated and completed with intraocular forceps. Specimens were submitted to light and electron microscopy.
Results: :
The natural dyes were a useful tool to allow the posterior vitreous detachment and internal limiting membrane peeling. Extract of haematoxylon campechianum, cochineal and fustec wood allows posterior vitreous detachment in 100% of the cases. The results of posterior hyaloid detachment assisted by these vital dyes were comparable with posterior hyaloid detachment assisted by triamcinolone previously performed in such model for comparison purposes. Cochineal and chlorophyll were the best dyes to stain de ILM. Chlorophyll allows intensely staining (comparable with ICG, tested before in cadaveric eyes) in 25% of the eyes and moderately in 75% of the eyes. Cochineal stains intensely in 50% of the eyes, 37,5% moderately and 12.5% poorly. Light microscopic and ultrastructural studies confirmed removal of the ILM in all cases.
Conclusions: :
Natural vital dyes allow staining of the vitreous and ILM in human cadaveric eyes and may be an useful tool for vitreoretinal surgery. Cochineal was the best dye to stain the vitreous and ILM, following extract of haematoxylon campechianum and fustec wood for vitreous and clorophyll for ILM.
Keywords: vitreous • vitreoretinal surgery • retina