Outer retinal microstructure and visual function after macular hole surgery with and without Brilliant Blue G.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Microscopic Imaging

Background:

• Idiopathic macular holes (MH) are a common cause of visual impairment.
• Internal limiting membrane (ILM) peeling is a standard surgical technique for MH repair.
• The role of adjunctive dyes like Brilliant Blue G (BBG) in improving surgical outcomes requires further investigation.

Purpose of the Study:

• To compare the efficacy of internal limiting membrane (ILM) peeling with and without Brilliant Blue G (BBG) staining for idiopathic macular hole (MH) surgery.
• To evaluate the impact of BBG staining on outer retinal microstructure recovery and visual function post-MH surgery.

Main Methods:

• Retrospective analysis of 49 eyes from 47 patients undergoing MH surgery.
• Patients were divided into two groups: ILM peeling without dye (control) and ILM peeling with BBG staining.
• Outer retinal microstructure (photoreceptor ellipsoid zone (EZ), external limiting membrane (ELM), and interdigitation zone (IZ)) defects were measured.

Main Results:

• Macular hole closure rates were high in both groups (95.6% control, 100% BBG group).
• Faster recovery of ellipsoid zone (EZ) defects and superior visual acuity were observed in the BBG group at 1 and 12 months postoperatively.
• No significant difference in external limiting membrane (ELM) or interdigitation zone (IZ) recovery between the groups.

Conclusions:

• Brilliant Blue G (BBG) assisted macular hole (MH) surgery promotes faster outer retinal structure recovery.
• BBG staining is associated with improved visual function outcomes after MH surgery compared to standard ILM peeling.
• BBG may be a valuable adjunct in enhancing surgical results for idiopathic macular holes.