title: Posterior hyaloid detachment and internal limiting membrane peeling assisted by anthocyanins from acai fruit (Euterpe oleracea) and 10 other natural vital dyes: experimental study in cadaveric eyes.
abstract: OBJECTIVE
  The purpose of this study was to determine whether natural dyes facilitate posterior hyaloid detachment (posterior vitreous detachment [PVD]) and retinal internal limiting membrane (ILM) peeling in human eyes.
  
  
  METHODS
  Open-sky vitrectomy with posterior hyaloid and ILM removal was performed in 86 human cadaveric eyes. After core vitrectomy, 11 different dyes were injected into the vitreous cavity to aid hyaloid detachment and ILM removal. The dyes were allowed to settle on the macula for 5 minutes after PVD and were removed by mechanical aspiration. Intraocular forceps were used for ILM peeling, which was confirmed by light microscopy of the peeled tissue. Acai fruit (Euterpe oleracea) extract and 10 additional dyes from plants or animal sources were tested: pomegranate (Punica granatum), logwood (Haematoxylum campechianum), chlorophyll extract from alfalfa (Medicago sativa), cochineal (Dactylopius coccus), hibiscus (Hibiscus rosa-sinensis), indigo (Indigofera tinctoria), paprika (Capiscum annuum), turmeric (Curcuma longa), old fustic (Maclura tinctoria), and grape (Vitis vinifera).
  
  
  RESULTS
  The dyes facilitated PVD and ILM peeling. Acai fruit (E. oleracea) extract, logwood (H. campechianum), cochineal (D. coccus), and old fustic (M. tinctoria) facilitated PVD in all cases; dye-assisted PVD was compared with triamcinolone-assisted PVD performed previously in a comparative model. Acai fruit (E. oleracea) extract, cochineal (D. coccus), and chlorophyll extract from alfalfa (M. sativa) showed the best capability for ILM staining; dye-assisted ILM removal was compared with the ILM peeling guided by indocyanine green staining performed previously in a comparative model. Light microscopy confirmed the ILM removal in all cases.
  
  
  CONCLUSIONS
  Anthocyanin dye of the acai fruit (E. oleracea) and the dyes from cochineal (D. coccus) and chlorophyll extract from alfalfa (M. sativa) resulted in the best capability for posterior hyaloid and ILM staining in human cadaveric eyes and may be a useful tool for vitreoretinal surgery.
authors.affiliation: Department of Ophthalmology, Vision Institute (IPEPO), Paulista School of Medicine, Federal University of Sao Paulo, Brazil.
authors.forename: Jane
authors.initials: J
authors.lastname: Chen
authors.forename: Magno Antonio
authors.initials: MA
authors.lastname: Ferreira
authors.forename: Michel Eid
authors.initials: ME
authors.lastname: Farah
authors.forename: André Maia
authors.initials: AM
authors.lastname: de Carvalho
authors.forename: Raquel Eustaquio
authors.initials: RE
authors.lastname: Alves Ferreira
authors.forename: Milton Nunes
authors.initials: MN
authors.lastname: de Moraes Filho
authors.forename: Acácio Alves
authors.initials: AA
authors.lastname: Souza Lima-Filho
authors.forename: João Henrique G
authors.initials: JH
authors.lastname: Lago
authors.forename: Patricia
authors.initials: P
authors.lastname: Sartorelli
authors.forename: Eduardo Buchele
authors.initials: EB
authors.lastname: Rodrigues
authors.forename: Eber
authors.initials: E
authors.lastname: Ferreira
authors.forename: Cristiane
authors.initials: C
authors.lastname: Peris
authors.forename: Maurício
authors.initials: M
authors.lastname: Maia
mesh_terms: D000872:Anthocyanins / Q000008:administration & dosage*; D028023:Arecaceae / Q000737:chemistry*; D001485:Basement Membrane / Q000601:surgery; D002102:Cadaver; D002851:Chromatography, High Pressure Liquid; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery*; D005638:Fruit / Q000737:chemistry*; D006801:Humans; D010860:Pigments, Biological / Q000008:administration & dosage*; D010936:Plant Extracts / Q000737:chemistry; D021241:Spectrometry, Mass, Electrospray Ionization; D013194:Staining and Labeling / Q000379:methods; D013396:Suction; D014019:Tissue Donors; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000175:diagnosis / Q000601:surgery*
chemical_list: D000872:Anthocyanins; D010860:Pigments, Biological; D010936:Plant Extracts