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Eric J. Feron, MD; Marc Veckeneer, MD; Rita Parys-Van Ginderdeuren, MD; Alfons Van Lommel, PhD; Gerrit R. J. Melles, MD, PhD; Peter Stalmans, MD, PhD

Arch Ophthalmol. 2002;120:141-144.

Objective  To determine whether trypan blue staining facilitates epiretinal membrane (ERM) removal in proliferative vitreoretinopathy.

Methods  In 10 patients undergoing vitrectomy for proliferative vitreoretinopathy, ERM peeling was performed without staining the tissue, until no additional ERMs were clearly visible. Then, after a fluid-air exchange, 0.06% trypan blue solution was applied onto the retinal surface. After 1 minute, all excess dye was removed and, after an air-fluid exchange, ERM peeling was completed. Excised ERM specimens were analyzed by transmission electron microscopy.

Main Outcome Measures  For each patient, the efficacy of trypan blue staining of ERMs during surgery was scored.

Results  In all patients, intraoperative staining of ERMs with trypan blue was found to be a useful adjunct, since the dye consistently improved direct visualization and delineation of ERMs and facilitated ERM removal. A clear contrast was created between the stained ERMs and the nonstaining, underlying retina. Electron microscopy showed that only ERM tissue was removed. No adverse reactions related to the use of the dye were observed up to 3 months after surgery.

Conclusions  Trypan blue may be an important new tool in the surgical management of proliferative vitreoretinopathy, since it may allow a more complete and safer ERM removal.

From the Rotterdam Eye Hospital, Rotterdam, the Netherlands (Drs Feron and Veckeneer); Departments of Ophthalmology (Drs Parys-Van Ginderdeuren and Stalmans) and Pathology (Dr Van Lommel), Universitair Ziekenhuis Leuven, Leuven, Belgium; and Netherlands Institute for Innovative Ocular Surgery, Rotterdam (Dr Melles). The Netherlands Institute for Innovative Ocular Surgery has proprietary and financial interest in a commercially available 0.06% solution of trypan blue for intraocular use (VisionBlue; Dutch Ophthalmic Research Center, Zuidland, the Netherlands), which is not yet available in the United States.

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