title: A comparison of brilliant blue G, trypan blue, and indocyanine green dyes to assist internal limiting membrane peeling during macular hole surgery.
abstract: OBJECTIVE
  To compare surgical outcomes with three dyes, brilliant blue G (BBG), trypan blue (TB) and indocyanine green (ICG), used to facilitate internal limiting membrane peeling during macular hole surgery.
  
  
  METHODS
  This comparative, interventional cases series consisted of 50 eyes of 50 patients with senile idiopathic macular holes, who underwent vitrectomy with internal limiting membrane peeling using BBG (n = 15), TB (n = 20), or ICG (n = 15). The cases involving use of BBG and TB were enrolled prospectively and concurrently, and the cases using ICG were selected through chart reviews. We compared the intraoperative surgical facilitation with the 3 dyes and the surgical outcomes in terms of macular hole closure and visual improvement at 6 months.
  
  
  RESULTS
  The 3 groups were similar in mean age, sex distribution, preoperative best-corrected visual acuity, and duration of follow-up (P = 0.957, 0.974, 0.939, and 0.5524, respectively). Of the 3 dyes, BBG appeared to provide greatest intraoperative facilitation: most convenient to use and remove, and similar to ICG in terms of internal limiting membrane staining. Six months postoperatively, macular hole closed in 100%, 95%, and 86% eyes (P = 0.48) and visual improvement occurred in 80%, 85%, and 33% eyes (P = 0.005) in BBG, TB, and ICG groups, respectively. The BBG and TB groups also had a better final best-corrected visual acuity than ICG group (P = 0.05) and smaller percentage of visual decline (5% and 6.7% vs. 40% respectively; P = 0.049).
  
  
  CONCLUSIONS
  Brilliant blue G was comparable with TB in optimizing visual and functional outcomes, while it was similar to ICG in ease of internal limiting membrane peeling.
authors.affiliation: Retina-Vitreous Service, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India. daksh66@gmail.com
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Shukla
authors.forename: Jay
authors.initials: J
authors.lastname: Kalliath
authors.forename: Nithya
authors.initials: N
authors.lastname: Neelakantan
authors.forename: Kannan B
authors.initials: KB
authors.lastname: Naresh
authors.forename: Kim
authors.initials: K
authors.lastname: Ramasamy
mesh_terms: D001485:Basement Membrane / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013997:Time Factors; D014343:Trypan Blue; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D004396:Coloring Agents; D005466:Fluorocarbons; D012394:Rosaniline Dyes; C042852:perflutren; D014343:Trypan Blue; D007208:Indocyanine Green; C004692:coomassie Brilliant Blue; D013459:Sulfur Hexafluoride