Dye extrusion technique (DE-TECH): occult retinal break detection with subretinal dye extrusion during vitrectomy for retinal detachment repair.

OBJECTIVE

To investigate the effectiveness of a new technique for the identification of occult retinal breaks in vitrectomy retinal detachment repair. Dye Extrusion Technique involves injection of sub retinal dye and extrusion through the unidentified breaks using perfluorocarbon liquid.

METHOD

Retrospective case note analysis.

MAIN OUTCOME MEASURES

rate of break detection, rate of use of local retinopexy, and short-term gas tamponade alone;

SECONDARY OUTCOMES

anatomical success at 3 months with no long-term tamponade, final visual acuity, progression of proliferative vitreoretinopathy.

RESULTS

Thirty-eight percent of eyes had proliferative vitreoretinopathy of grade C1 or worse. Twenty-five percent underwent primary retinal detachment repair surgery. The remainder underwent repeat operations for previously failed surgery. Breaks were found in 89% of eyes and 81% underwent only local retinopexy and gas tamponade. The overall anatomical success rate was 85% (40/47) which included four cases in which the retina was fully attached awaiting removal of silicone oil. No cases had unexplained loss of vision. No progression of proliferative vitreoretinopathy was noted.

CONCLUSIONS

Results suggest that Dye Extrusion Technique may be an effective technique for the identification of occult retinal breaks and may facilitate simple techniques of detachment repair. No evidence of retino-toxicity from the use of trypan blue was found but the study had limited power to detect adverse effects.