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New application of membrane blue-dual dye for retinal or iatrogenic break staining in retinal detachment surgery
1St Demetrios Hospital, Thessaloniki, Greece. liapapava@hotmail.com.
Introduction:
The principles of surgery for managing primary rhegmatogenous retinal detachment (RRD) are to precisely identify and correctly treat all causative retinal breaks. Estimates regarding unidentified breaks complicating RRDs vary from 2.2%-22.5%.
Purpose:
To evaluate the efficacy of membrane blue-dual heavy dye solution for staining of undetected preoperatively retinal and iatrogenic breaks.
Subjects, Material And Methods:
1. This is a prospective interventional study. 23 and 27-gauge vitrectomy surgeries were evaluated for primary repair of 5 patients with rhegmatogenous retinal detachment (RRD). No breaks where identified prior to surgery despite meticulous pre-operative examination using binocular indirect ophthalmoscopy with indentation. 0.1ml of MembraneBlue-Dual™ was applied onto the vitreous cavity, while it was completely filled with fluid, and all excess dye was immediately aspirated with a blunt backflush instrument. In all eyes with RRD, the surgery was completed by gas tamponade (C3F8 or SF6). Follow up was 6 months.
Results:
We compared the number of breaks identified when examined intraoperative with internal peripheral indentation before and after injection of the dye and found that in all cases (100%) at least one more break was found after injection of dye which was subsequently treated with cryotherapy or endolaser. At last follow up six months after surgery the success rate was 100% and none of our cases re-detached.
Conclusions:
The greatest advantage of use of this "heavy" dye solution membrane blue-dual is improved intraoperative identification of ILM at the edges of retinal breaks and the discrimination of them from surrounding intraocular structures. Due to its increased molecular weight and viscosity properties it eliminates the need for fluid-air exchange, injection of PFCL or subretinal injection.
Insights
Membrane Blue-Dual effectively identifies previously undetected retinal breaks during surgery for rhegmatogenous retinal detachment (RRD). This heavy dye solution improves visualization, leading to 100% surgical success and no re-detachments in this study.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Primary rhegmatogenous retinal detachment (RRD) management requires precise identification and treatment of all causative retinal breaks.
- Undetected retinal breaks complicate 2.2%-22.5% of RRD cases, necessitating improved diagnostic methods.
Purpose of the Study:
- To assess the efficacy of Membrane Blue-Dual, a heavy dye solution, in staining and identifying retinal breaks missed during preoperative examination.
- To evaluate its utility in detecting both primary and iatrogenic retinal breaks.
Main Methods:
- A prospective interventional study involving 5 patients undergoing 23/27-gauge vitrectomy for primary RRD.
- Membrane Blue-Dual was injected into the vitreous cavity after preoperative examination failed to identify breaks.
- Internal peripheral indentation was used intraoperatively before and after dye injection.
Main Results:
- The dye injection led to the identification of at least one additional retinal break in 100% of cases.
- These newly identified breaks were successfully treated with cryotherapy or endolaser.
- All patients achieved a 100% surgical success rate with no retinal re-detachment at 6-month follow-up.
Conclusions:
- Membrane Blue-Dual significantly improves intraoperative identification of retinal breaks by enhancing visualization of the internal limiting membrane (ILM).
- Its properties eliminate the need for fluid-air exchange, perfluorocarbon liquids (PFCL), or subretinal injections.
- This heavy dye offers a valuable tool for enhancing surgical outcomes in RRD repair.
