[Comparative results of macular hole surgery with and without internal limiting membrane staining with Brilliant Blue...

To evaluate the role of Brilliant Blue G (BBG) in macular hole (MH) surgery.

Comparative retrospective study between two groups of 20 consecutive patients who underwent macular hole surgery. In the first group (G1), the inner limiting membrane (ILM) was systematically peeled without staining, while in the second group (G2), BBG was consistently utilized. Pre- and postoperative logMAR visual acuities (VA) were studied, as well as macular optical coherence tomography (OCT) scans to measure MH size, to confirm postoperative closure and to evaluate the integrity of the IS/OS junction. Time required and difficulty of peeling were compared between the two groups. Minimum follow-up was six months.

After six months follow-up, the average improvement in acuity was 0.56±0.48 logMAR for G1, versus 0.60±0.44 logMAR for G2 (P=0.80). The rate of closure after one surgery was 85% (17/20 patients) for G1, versus 95% (19/20 patients) for G2 (P=0.29). Postoperative OCT appearance of the IS/OS junction was similar in both groups: intact in 16/20 patients (80%), disrupted in 3/20 patients (15%), and indeterminate in 1/20 patients (5%) (P=1). The mean duration of peeling in G1 was 270.9±27.4 seconds. It was deemed difficult in ten eyes and incomplete in two patients, while in the G2 group, the mean duration of ILM peeling was 140.8±37.6 seconds (P<0.01); it was deemed complete and technically easy in all cases.

The use of BBG was effective in facilitating and accelerating ILM peeling during MH surgery. The anatomical and functional results were not statistically better in the group that received BBG.