The Combination of Trypan Blue and Brilliant Blue G-Assisted Vitrectomy for Macular Pucker: Histopathological Findings

Ophthalmologica. 2018;239(2-3):167-175. doi: 10.1159/000485986. Epub 2018 Jan 25.

Abstract

Purpose: To report on the combined use of trypan blue (TB) and brilliant blue G (BBG) for staining the epiretinal membrane (ERM) and internal limiting membrane (ILM) during vitrectomy and to describe the histopathological findings.

Methods: 10 surgical specimens were removed from 10 eyes with macular pucker during vitrectomy using a commercially available combination of TB and BBG for ERM and ILM staining and peeling. Specimens were evaluated using light and transmission electron microscopy.

Results: In all cases the combination of TB and BBG was useful for identifying and delineating ERM and ILM. No complications related to the use of the dye were observed during or after surgery. Glial cells were present in all specimens. Hyalocytes were observed in 6 cases and myofibroblasts in 3 of them. In 7 cases native vitreous collagen fibrils were found on the ILM, while in 5 specimens newly formed collagen was present. No clinical evidence of toxicity was observed during the 3-month follow-up.

Conclusion: The combined use of TB and BBG appeared to be very useful intraoperatively to improve the visualization of ERM and ILM, thus facilitating their complete removal. Anatomical and histopathological findings demonstrated the safety and the efficacy of this vital dye.

Keywords: Epiretinal membrane; Internal limiting membrane; Light microscopy; Transmission electron microscopy; Vital dyes; Vitrectomy.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Basement Membrane / surgery*
  • Basement Membrane / ultrastructure
  • Coloring Agents / therapeutic use
  • Epiretinal Membrane / diagnosis
  • Epiretinal Membrane / physiopathology
  • Epiretinal Membrane / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Indicators and Reagents / pharmacology
  • Intraoperative Period
  • Macula Lutea / ultrastructure*
  • Male
  • Microscopy, Electron, Transmission
  • Prospective Studies
  • Rosaniline Dyes / pharmacology*
  • Single-Blind Method
  • Time Factors
  • Trypan Blue / pharmacology*
  • Visual Acuity*
  • Vitrectomy / methods*

Substances

  • Coloring Agents
  • Indicators and Reagents
  • Rosaniline Dyes
  • Trypan Blue
  • coomassie Brilliant Blue