title: Use of lutein and zeaxanthin alone or combined with Brilliant Blue to identify intraocular structures intraoperatively.
abstract: OBJECTIVE
  To determine whether a natural dye solution based on lutein and zeaxanthin alone or combined with Brilliant Blue stains and facilitates peeling of intraocular membranes in human eyes.
  
  
  METHODS
  In this study of 60 cadaveric eyes, open-sky vitrectomy including posterior hyaloid detachment was performed. Different lutein and zeaxanthin concentrations (0.01-20%) were tested alone or combined with different Brilliant Blue concentrations (0.0125-0.025%) in the corneal endothelium, corneal epithelium, anterior and posterior capsule, vitreous cavity through the macula including the posterior hyaloid, and internal limiting membrane. The various dye solutions were in contact with the intraocular membranes for <1 minute and then were removed by mechanical aspiration or membrane peeling initiated and completed with intraocular forceps. The specimens were examined by light and electron transmission microscopy.
  
  
  RESULTS
  Contact between lutein and zeaxanthin and the retinal, lens, and vitreous surface resulted in orange and greenish staining of the intraocular membranes, which facilitated surgical steps in all eyes. Lutein and zeaxanthin alone was useful for vitreous identification and lutein and zeaxanthin combined with Brilliant Blue had strong affinity for internal limiting membrane and anterior capsule. Light microscopy confirmed internal limiting membrane removal in all eyes tested. No dye solutions remained in the eyes after the membrane removal.
  
  
  CONCLUSIONS
  A natural dye solution based on lutein and zeaxanthin alone or combined with Brilliant Blue efficiently stained the anterior capsule, vitreous, and internal limiting membrane in human cadaveric eyes and may be a useful tool for vitreoretinal or cataract surgery.
authors.affiliation: Instituto da Visão (IPEPO), Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Diogo
authors.initials: D
authors.lastname: Sousa-Martins
authors.forename: Maurício
authors.initials: M
authors.lastname: Maia
authors.forename: Milton
authors.initials: M
authors.lastname: Moraes
authors.forename: Acácio A S
authors.initials: AA
authors.lastname: Lima-Filho
authors.forename: Eduardo B
authors.initials: EB
authors.lastname: Rodrigues
authors.forename: Jane
authors.initials: J
authors.lastname: Chen
authors.forename: Michel E
authors.initials: ME
authors.lastname: Farah
authors.forename: Leticia B
authors.initials: LB
authors.lastname: Santos
authors.forename: Rubens
authors.initials: R
authors.lastname: Belfort
mesh_terms: D057866:Anterior Capsule of the Lens / Q000033:anatomy & histology* / Q000648:ultrastructure; D001485:Basement Membrane / Q000033:anatomy & histology* / Q000648:ultrastructure; D001557:Benzenesulfonates / Q000737:chemistry / Q000633:toxicity; D002387:Cataract Extraction; D004396:Coloring Agents / Q000737:chemistry / Q000633:toxicity; D004338:Drug Combinations; D006801:Humans; D007432:Intraoperative Period; D014975:Lutein / Q000737:chemistry / Q000633:toxicity; D013194:Staining and Labeling / Q000379:methods; D057586:Vitreoretinal Surgery; D014822:Vitreous Body / Q000033:anatomy & histology* / Q000648:ultrastructure; D024341:Xanthophylls / Q000737:chemistry / Q000633:toxicity; D065146:Zeaxanthins
chemical_list: D001557:Benzenesulfonates; D004396:Coloring Agents; D004338:Drug Combinations; D024341:Xanthophylls; D065146:Zeaxanthins; C006796:brilliant blue; D014975:Lutein