Farah Michel Eid, Maia Mauricio, Rodrigues Eduardo B
Vision Institute, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.
Am J Ophthalmol. 2009 Sep;148(3):332-40. doi: 10.1016/j.ajo.2009.04.003. Epub 2009 May 24.
To present the current state-of-the-art information regarding the properties, indications, surgical techniques, and toxic effects of current and past applications of vital dyes in chromovitrectomy.
Critical analysis and surgical perspective of the literature and recent studies.
Review, interpretation, and commentary regarding the most relevant experimental as well as clinical studies including the authors' clinical and laboratory research.
There is a consensus that the application of vital dyes facilitates the delicate removal of intraocular membranes during vitreoretinal surgery. Controversy still remains around various issues, mainly potential toxicity and safety. There is room for further investigation of novel and specific vital dyes. Dyes such as Evans blue and light green may stain the internal limiting membrane very well, whereas fast green and indigo carmine may be very safe to the retina. However, comparing the staining and toxicity data has revealed that Bromophenol blue and Brilliant blue may be even better novel agents. The dyes currently used for different steps in chromovitrectomy are: triamcinolone acetonide for vitreous identification; indocyanine green, infracyanine green, and Brilliant blue for internal limiting membrane identification; and Trypan blue for epiretinal membrane identification.
Clear-cut safety profiles for the different dyes in chromovitrectomy have not yet been established, and current state-of-the-art staining-assisted procedures should be performed using concentrations and volumes as low as possible.
介绍有关活性染料在染色玻璃体切割术中当前及过去应用的特性、适应证、手术技术和毒性作用的最新技术信息。
对文献及近期研究进行批判性分析和手术视角探讨。
对最相关的实验及临床研究进行综述、解读和评论，包括作者的临床及实验室研究。
人们一致认为，活性染料的应用有助于在玻璃体视网膜手术中精细地去除眼内膜。围绕各种问题仍存在争议，主要是潜在毒性和安全性。新型特异性活性染料仍有进一步研究的空间。伊文思蓝和亮绿等染料可能很好地染色内界膜，而固绿和靛胭脂对视网膜可能非常安全。然而，比较染色和毒性数据表明，溴酚蓝和亮蓝可能是更好的新型试剂。目前在染色玻璃体切割术不同步骤中使用的染料有：曲安奈德用于识别玻璃体；吲哚菁绿、红外菁绿和亮蓝用于识别内界膜；锥虫蓝用于识别视网膜前膜。
尚未确立不同染料在染色玻璃体切割术中明确的安全性概况，当前的最新染色辅助手术应使用尽可能低的浓度和体积进行。
