title: A preliminary study of Heavy Brilliant Blue G for internal limiting membrane staining in macular hole surgery.
abstract: BACKGROUND
  Surgical outcomes of vitrectomy for idiopathic macular hole using a "heavy" Brilliant Blue G (HBBG) solution for staining and removal of the internal limiting membrane (ILM).
  
  
  METHODS
  Prospective interventional case series conducted in a tertiary eye care hospital.
  
  
  METHODS
  Nineteen patients (20 eyes) with idiopathic macular hole were enrolled to undergo vitrectomy with ILM peeling using HBBG. BBG dye was made heavy by mixing with 10% dextrose normal saline (DNS) solution in 2:1 ratio. The adequacy of ILM staining was noted intraoperatively. The closure rates of macular hole and visual improvement were recorded. Patients were followed up postoperatively on day 1, week 1, and subsequently at 1, 3, and 6 months, and every 6th month thereafter.
  
  
  METHODS
  Wilcoxon signed-rank test was used; P < 0.05 was considered significant.
  
  
  RESULTS
  Preoperative best-corrected visual acuity (BCVA) ranged from 20/1000 to 20/63 (median: 20/100). Intraoperatively, the ILM stained very well in all eyes, and was easily removed. All macular holes closed postoperatively. The mean follow-up was 6.15 ± 2 months (range: 4-10; median: 6 months). Final BCVA ranged from 20/20 to 20/80 (median: 20/40), amounting to a significant visual improvement (P = 0.0001). BCVA improved by 1-8 Snellen lines in 19 eyes (95%); 16 eyes (80%) improved by ≥2 lines; 13 eyes (65%) achieved a final BCVA of 20/40 or better.
  
  
  CONCLUSIONS
  Addition of 10% DNS to BBG dye allowed good ILM staining with less dye during macular hole surgery, and provided excellent anatomic and visual outcomes.
authors.affiliation: Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Shukla
authors.forename: Jay
authors.initials: J
authors.lastname: Kalliath
authors.forename: Aditi
authors.initials: A
authors.lastname: Patwardhan
authors.forename: Naresh B
authors.initials: NB
authors.lastname: Kannan
authors.forename: Soubhya B
authors.initials: SB
authors.lastname: Thayyil
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007202:Indicators and Reagents; D007432:Intraoperative Period; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012167:Retinal Perforations / Q000473:pathology / Q000601:surgery*; D012394:Rosaniline Dyes; D013194:Staining and Labeling
chemical_list: D007202:Indicators and Reagents; D012394:Rosaniline Dyes; C004692:coomassie Brilliant Blue