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M. Perrier, M. Sébag, D. Gauthier; Trypan Blue Assisted Peeling of the Internal Limiting Membrane During Macular Hole and Epiretinal Membrane Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4888.
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Purpose To evaluate the surgical and visual outcome of patients who have undergone surgery for macular holes or epiretinal membranes using trypan blue to facilitate visualisation and delamination of the internal limiting membrane. Method A retrospective noncomparative review of a consecutive series of patients. All patients underwent a three-port pars plana vitrectomy with internal membrane delamination using trypan blue 0,06% to assist in visualisation. Of the patients included in the study, 23 had epiretinal membranes and 18 had macular holes. The main outcome measures were postoperative visual acuity and clinically evident postoperative retinal pigment epithelial changes. Results Of the patients who underwent epiretinal membrane peeling, the median best-corrected preoperative visual acuity was 20/100 with a range from 20/50 to counting fingers at one feet. The median best-corrected postoperative visual acuity was 20/60 ranging from 20/20 to 20/400. At the last recorded follow-up, 17 patients (74%) had improved their visual acuity of at least 2 chart lines. In the macular hole group, the median best-corrected preoperative visual acuity was 20/200 with a range from 20/50 to counting fingers at one feet. The median best-corrected postoperative visual acuity was 20/70 ranging from 20/25 to counting fingers at 5 feet. All but one macular hole was closed after surgery (94%). At the last recorded follow-up, 10 patients (56%) had improved their visual acuity of at least 2 chart lines. For all 41 cases, no adverse reaction related to trypan blue was observed up to 1 year after surgery. Conclusion Trypan blue staining of ILM and epiretinal membranes may help vitreoretinal surgeons accomplish more complete dissections of the ILM and better surgical and visual outcomes.
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