Wirbelauer C, Häberle H, Pham D T
Klinik für Augenheilkunde, Klinikum Frankfurt (Oder) GmbH, Müllroser Chaussee 7, Frankfurt (Oder).
Klin Monbl Augenheilkd. 2011 Jan;228(1):62-5. doi: 10.1055/s-0029-1245433. Epub 2010 Sep 15.
Staining of the retinal surface has improved the intraoperative removal of semitransparent membranes during macular surgery. The purpose of this study was to evaluate the clinical experiences with brilliant blue G (BBG) staining of the retinal surface.
BBG (Brilliant peel, Fluoron) was applied during vitrectomy and macular surgery in 43 patients. In 47 % there was a macular hole (MH), whereas 53 % had epiretinal membranes (ERM). Intraoperatively BBG was applied on the retinal surface under infusion or air conditions for 30 - 60 s. In MH the internal limiting membrane (ILM) and in ERM the membrane was removed. Postoperatively all patients were examined on average after 9 weeks.
Although intraoperative BBG staining was less intensive compared to ICG staining, the staining was sufficient to safely remove the semitransparent membranes in all cases. In all patients with MH hole closure was achieved, and in 96 % with ERM the metamorphopsiae decreased. The mean decimal visual acuity increased from 0.25 ± 0.13 to 0.37 ± 0.20 (p < 0.05) and improved in 63 % of the patients. Clinically, there were no toxic side-effects from BBG staining.
BBG allowed a complete and selective staining of the retinal surface. Thus, ILM and ERM could be removed safely during macular surgery. No clinical retinal toxicity was observed.
视网膜表面染色有助于在黄斑手术中更有效地移除半透明膜。本研究旨在评估视网膜表面使用亮蓝G(BBG)染色的临床经验。
43例患者在玻璃体切除术和黄斑手术中使用了BBG(Brilliant peel,Fluoron)。其中47%患有黄斑裂孔(MH),53%患有视网膜前膜(ERM)。术中在灌注或空气条件下将BBG应用于视网膜表面30 - 60秒。对于MH患者,移除内界膜(ILM);对于ERM患者,移除视网膜前膜。术后所有患者平均在9周后接受检查。
尽管术中BBG染色强度低于吲哚菁绿(ICG)染色,但该染色足以在所有病例中安全移除半透明膜。所有MH患者均实现裂孔闭合,96%的ERM患者变形视症减轻。平均小数视力从0.25±0.13提高到0.37±0.20(p<0.05),63%的患者视力得到改善。临床上,BBG染色未出现毒性副作用。
BBG可实现视网膜表面的完全选择性染色。因此,在黄斑手术中可安全移除ILM和ERM。未观察到临床视网膜毒性。