Treatment of proliferative diabetic retinopathy using viscosurgery with vital dye

Viscosurgery is a surgical procedure based on the injection of viscoelastic material between the retinal surface and the fibrovascular tissue in proliferative diabetic retinopathy (PDR), with the aim of separating these structures to facilitate their dissection. We describe a modified viscosurgical technique in which the viscoelastic material is combined with a vital dye (trypan blue), which allows us to determine the degree of adhesion between the structures. Viscosurgery with vital dye has advantages compared with conventional viscosurgery and constitutes a useful surgical approach in complicated cases of severe PDR, enhancing efficiency and safety in the dissection of fibrovascular proliferations and minimizing iatrogenic damage to the underlying retina. We used trypan blue viscosurgery in 8 eyes of 8 patients with severe PDR; in all cases, a satisfactory outcome was obtained without evidence of any complications.