Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.
Retina. 2014 Feb;34(2):262-72. doi: 10.1097/IAE.0b013e3182a0b7f4.
To evaluate the feasibility, advantages, and safety of a novel lutein-based dye for improving identification and removal of the vitreous, internal limiting membrane, and epiretinal membrane during chromovitrectomy in humans.
We prospectively evaluated 12 eyes that underwent pars plana vitrectomy using the dye in patients with macular hole, epiretinal membrane, or proliferative diabetic retinopathy/tractional diabetic macular edema. One surgeon performed standard chromovitrectomy and completed a postoperative questionnaire to compare the staining with that of the available dyes. The peeled membranes were evaluated histologically. Follow-up examinations were performed on postoperative Days 1, 7, 30, 90 and 180; best-corrected visual acuity, optical coherence tomography, fluorescein angiography, autofluorescence, and visual fields were performed.
The green dye was deposited on the posterior pole because of its higher density than balanced saline solution; vigorous dye flushing into the vitreous cavity was unnecessary. The dye stained the posterior hyaloid/vitreous base by deposition onto the vitreous; brilliant blue stained the internal limiting membrane. The epiretinal membrane was poorly stained. The best-corrected visual acuity improved in all eyes without clinical toxicity or toxicity on images/visual fields. Histology showed effective removal of the internal limiting membrane and epiretinal membrane in all eyes.
The new dye improved intraoperative identification of the internal limiting membrane and the posterior hyaloid/vitreous base during chromovitrectomy.
评估一种新型叶黄素基染料在人眼 chromovitrectomy 中改善玻璃体、内界膜和视网膜前膜识别和切除的可行性、优势和安全性。
我们前瞻性评估了 12 只接受黄斑裂孔、视网膜前膜或增生性糖尿病性视网膜病变/牵引性糖尿病性黄斑水肿患者行 pars plana 玻璃体切除术的眼睛，使用该染料。一名外科医生进行了标准 chromovitrectomy，并完成了术后问卷调查，以比较染色与现有染料的染色。剥离的膜进行了组织学评估。在术后第 1、7、30、90 和 180 天进行随访检查；进行最佳矫正视力、光学相干断层扫描、荧光素血管造影、自发荧光和视野检查。
由于密度高于平衡盐溶液，绿色染料沉积在后极，因此不需要剧烈冲洗玻璃体腔。染料通过沉积在玻璃体上使后玻璃体/玻璃体基底染色；亮蓝染色内界膜。视网膜前膜染色不佳。所有眼睛的最佳矫正视力均有所提高，无临床毒性或图像/视野毒性。组织学显示所有眼睛均有效去除了内界膜和视网膜前膜。
新型染料在 chromovitrectomy 中改善了内界膜和后玻璃体/玻璃体基底的术中识别。
