Trypan blue selective staining using whole blood for internal limiting membrane peeling during macular hole corrective surgery.
OBJECTIVE
To prevent trypan blue (TB) retention and its potential toxicity by selectively staining the internal limiting membrane (ILM) with the aid of whole blood.


METHODS
Twenty-four consecutive patients with macular holes who underwent TB-assisted ILM peeling were enrolled. In the surgeries, autologous whole blood was applied to cover the macular hole, and only the area selectively used for TB staining was exposed. Trypan blue solution (0.75 mg/mL, after being diluted with 5% glucose) was used to stain the exposed macular area in the fluid-filled vitreous cavity. The stained ILM was then completely removed.


RESULTS
Twenty-four macular holes were studied. The ILMs were selectively stained by trypan blue and then removed completely. No visible dye remained on the retina after peeling. The macular holes were closed in 22 eyes (92%) after a single surgery. The mean best-corrected visual acuity improved from 20/140 to 20/62 after surgery. In addition, no fundus changes were observed during the follow-up period.


CONCLUSIONS
Selective staining of ILM during TB-assisted membrane peeling could be achieved with whole blood as the adjuvant. Complete removal of stained membranes can prevent TB retention and may further reduce toxicity on retinal pigment epithelium and retina.
Lai
Chi-Chun
CC
Department of Ophthalmology, Chang-Gung Memorial Hospital, Taoyuan, Taiwan. ccl404@cgmh.org.tw
Chuang
Lan-Hsin
LH
Wang
Nan-Kai
NK
Yeung
Ling
L
Chen
Yen-Po
YP
Hwang
Yih-Shiou
YS
Chen
Kuan-Jen
KJ
Wu
Wei-Chi
WC
D000328:Adult; D000368:Aged; D001769:Blood; D004396:Coloring Agents / Q000633:toxicity*; D019773:Epiretinal Membrane / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D012167:Retinal Perforations / Q000378:metabolism / Q000601:surgery*; D013194:Staining and Labeling / Q000379:methods; D014343:Trypan Blue / Q000633:toxicity*
D004396:Coloring Agents; D014343:Trypan Blue