title: Novel 'heavy' dyes for retinal membrane staining during macular surgery: multicenter clinical assessment.
abstract: OBJECTIVE
  To evaluate the feasibility of two novel 'heavy' dye solutions for staining the internal limiting membrane (ILM) and epiretinal membranes (ERMs), without the need for a prior fluid-air exchange, during macular surgery.
  
  
  METHODS
  In this prospective nonrandomized multicenter cohort study, the high molecular weight dyes ILM-Blue™ [0.025% brilliant blue G, 4% polyethylene glycol (PEG)] and MembraneBlue-Dual™ (0.15% trypan blue, 0.025% brilliant blue G, 4% PEG) were randomly used in vitrectomy surgeries for macular disease in 127 eyes of 127 patients. Dye enhanced membrane visualization of the ILM and ERMs, 'ease of membrane peeling', visually detectable perioperative retinal damage, postoperative best-corrected visual acuity (BCVA), dye remnants and other unexpected clinical events were documented by 21 surgeons.
  
  
  RESULTS
  All surgeries were uneventful, and a clear bluish staining, facilitating the identification, delineation and removal of the ILM and ERMs, was reported in all but five cases. None of the surgeries required a fluid-air exchange to assist the dye application. BCVA at 1 month after surgery improved in 83% of the eyes in the MembraneBlue-Dual™ group and in 88% in the ILM-Blue™ group. No dye remnants were detected by ophthalmoscopy, and no retinal adverse effects related to the surgery or use of the dyes were observed.
  
  
  CONCLUSIONS
  The 'heavy' dye solutions ILM-Blue™ and MembraneBlue-Dual™ can be injected into a fluid-filled vitreous cavity and may facilitate staining and removal of the ILM and/or ERMs in macular surgery without an additional fluid-air exchange.
authors.affiliation: Oogziekenhuis Rotterdam, Rotterdam, The NetherlandsSt. Joseph Stift, Bremen, GermanyAlhokama Eye Specialist Center, Riyadh, Saudi ArabiaDr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, IndiaAmerican University of Beirut, Beirut, LebanonDiv. Oculistica, Azienda Sanitaria dell'Alto Adige-Südtirol, Bolzano, ItalyLebanese American University, Lebanon and Saint Joseph University, Beirut, LebanonClinique Ophthalmologique et O.R.L. De Tunis, Tunis, TunesiaRabin Medical Center, Petah Tikva, IsraelInstituto Clínico Quirúrgico de Oftalmología, Bilbao, SpainLebanese American University of Beirut, Beirut, LebanonJordan Hospital, Amman, JordanAcademic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsOogziekenhuis Zonnestraal, Hilversum, The NetherlandsKlinika Okulistyczna, Okulistyczna 'Jasne Blonia', Lodz, PolandMedivision, Beacon Bay, South AfricaAurelios Augenzentrum, Recklinghausen, GermanyS. Fyodorov Eye Microsurgery State Institution, Moscow, RussiaKnappschaftskrankenhaus Sulzbach, Sulzbach, GermanyKeravision, Johannesburg, South AfricaUniversity of Hong Kong, Hong Kong, ChinaDelft University of Technology, Delft, The NetherlandsNetherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands.
authors.forename: Marc
authors.initials: M
authors.lastname: Veckeneer
authors.forename: Andreas
authors.initials: A
authors.lastname: Mohr
authors.forename: Essam
authors.initials: E
authors.lastname: Alharthi
authors.forename: Rajvardhan
authors.initials: R
authors.lastname: Azad
authors.forename: Ziad F
authors.initials: ZF
authors.lastname: Bashshur
authors.forename: Enrico
authors.initials: E
authors.lastname: Bertelli
authors.forename: Riad A
authors.initials: RA
authors.lastname: Bejjani
authors.forename: Brahim
authors.initials: B
authors.lastname: Bouassida
authors.forename: Dan
authors.initials: D
authors.lastname: Bourla
authors.forename: Iñigo Corcóstegui
authors.initials: IC
authors.lastname: Crespo
authors.forename: Charbel
authors.initials: C
authors.lastname: Fahed
authors.forename: Faisal
authors.initials: F
authors.lastname: Fayyad
authors.forename: Marco
authors.initials: M
authors.lastname: Mura
authors.forename: Jerzy
authors.initials: J
authors.lastname: Nawrocki
authors.forename: Kelvin
authors.initials: K
authors.lastname: Rivett
authors.forename: Gabor B
authors.initials: GB
authors.lastname: Scharioth
authors.forename: Dmitry O
authors.initials: DO
authors.lastname: Shkvorchenko
authors.forename: Peter
authors.initials: P
authors.lastname: Szurman
authors.forename: Hein
authors.initials: H
authors.lastname: Van Wijck
authors.forename: Ian Y
authors.initials: IY
authors.lastname: Wong
authors.forename: David S H
authors.initials: DS
authors.lastname: Wong
authors.forename: Johannes
authors.initials: J
authors.lastname: Frank
authors.forename: Silke
authors.initials: S
authors.lastname: Oellerich
authors.forename: Marieke
authors.initials: M
authors.lastname: Bruinsma
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D004338:Drug Combinations; D019773:Epiretinal Membrane / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D011092:Polyethylene Glycols; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery*; D012394:Rosaniline Dyes; D013194:Staining and Labeling / Q000379:methods; D014343:Trypan Blue; D014792:Visual Acuity / Q000187:drug effects; D014821:Vitrectomy
chemical_list: D004396:Coloring Agents; D004338:Drug Combinations; D007202:Indicators and Reagents; D012394:Rosaniline Dyes; D011092:Polyethylene Glycols; D014343:Trypan Blue; C004692:coomassie Brilliant Blue
keywords: brilliant blue G; epiretinal membrane; internal limiting membrane; macular surgery; polyethylene glycol (PEG); trypan blue