Vital dyes in macular hole surgery

Area of Science:

• Ophthalmology
• Retinal Surgery
• Ophthalmic Dyes

Background:

• Internal limiting membrane (ILM) peeling is a key surgical technique for various macular pathologies.
• Dyes like Brilliant Blue G are used to visualize the ILM during macular surgeries.
• The potential protective effects of different dyes on retinal tissues are not fully understood.

Purpose of the Study:

• To compare visual acuity and optical coherence tomography (OCT) changes after staining the ILM with Brilliant Blue G versus lutein/zeaxanthin-based dyes.
• To evaluate the intraoperative protective effects of these dyes on photoreceptors during pars plana vitrectomy.

Main Methods:

• A comparative study involving 30 eyes of 30 patients undergoing vitrectomy for idiopathic stage 4 macular hole.
• Patients were divided into two groups: 15 eyes stained with Brilliant Blue G and 15 eyes stained with lutein/zeaxanthin dyes.
• Surgical outcomes, including visual acuity, OCT changes, and intraocular pressure, were analyzed.

Main Results:

• Both staining methods, using the Alcon Constellation Vision System, showed no negative impact on cell viability and improved visual acuity by 30%.
• Lutein/zeaxanthin dyes demonstrated an intraoperative protective effect on photoreceptors compared to Brilliant Blue G.
• Staining facilitated precise and efficient ILM removal during macular surgery.

Conclusions:

• Both Brilliant Blue G and lutein/zeaxanthin dyes are effective for ILM staining in macular hole surgery, leading to improved visual acuity.
• Lutein/zeaxanthin dyes offer an added benefit of photoreceptor protection during the procedure.
• Surgical visualization techniques in ophthalmology continue to evolve, enhancing surgical precision and patient outcomes.