Identification of retinal breaks using subretinal trypan blue injection.
OBJECTIVE
To describe the use of subretinal trypan blue to identify retinal breaks during vitrectomy for rhegmatogenous retinal detachment (RD).


METHODS
Interventional case series.


METHODS
Five patients with RD in whom no retinal break could be identified by internal search with scleral indentation.


METHODS
Trypan blue 0.15% was injected transretinally into the subretinal space using a 41-gauge cannula designed for macular translocation surgery. Perfluorocarbon heavy liquid was then injected into the vitreous cavity and the eye was rotated such that trypan blue was vented out of the break. The plume of trypan blue was used to identify retinal breaks, or in some cases staining of the break facilitated break detection. Subretinal fluid was then drained through the break or a drainage retinotomy and surgery was completed using standard techniques.


METHODS
Identification of previously unseen retinal breaks.


RESULTS
This technique successfully identified a retinal break in 4 out of 5 patients. After absorption of the gas tamponade all retinas remained attached with a median visual acuity of 6/12.


CONCLUSIONS
Failure to identify a retinal break during RD surgery is a well-recognized clinical challenge that may adversely affect outcome. In this setting, chromophore-assisted retinal break detection may be a useful surgical technique.
Jackson
Timothy L
TL
Vitreoretinal Unit, Moorfields Eye Hospital, London, United Kingdom. TimLJackson@hotmail.com
Kwan
Anthony S L
AS
Laidlaw
Alistair H
AH
Aylward
William
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D004396:Coloring Agents / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D007431:Intraoperative Complications / Q000175:diagnosis*; D008297:Male; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000150:complications* / Q000175:diagnosis*; D014343:Trypan Blue / Q000008:administration & dosage; D014821:Vitrectomy
D004396:Coloring Agents; D014343:Trypan Blue