Brilliant blue G-assisted peeling of the internal limiting membrane in macular hole surgery

Abstract

Dye-assisted internal limiting membrane (ILM) peeling and gas tamponade is the surgery of choice for idiopathic macular holes. Indocyanine green and trypan blue have been extensively used to stain the ILM. However, the retinal toxicity of indocyanine green and non-uniform staining with trypan blue has necessitated development of newer vital dyes. Brilliant blue G has recently been introduced as one such dye with adequate ILM staining and no reported retinal toxicity. We performed a 23-gauge pars plana vitrectomy with brilliant blue G-assisted ILM peeling in six patients with idiopathic macular holes, to assess the staining characteristics and short-term adverse effects of this dye. Adequate staining assisted in the complete removal of ILM and closure of macular holes in all cases. There was no evidence of intraoperative or postoperative dye-related toxicity. Brilliant blue G appears to be safe dye for ILM staining in macular hole surgery.

Morphological and Functional Outcome after Brilliant Blue G-Assisted Macular Hole Surgery

“…Patients in that study were 60.8 ± 3.71 years old, whereas the patients in our study were 65.6 ± 7.4 years old. This might explain the lower macular hole closure rate in our case series [18]. Additionally, in our study, macular hole closure was defined as complete closure of the inner retinal dehiscence seen in OCT, which seems to be a very tight definition.…”

“…The median visual acuity was 20/100 preoperatively and postoperatively improved to 20/32 [13]. Naithani et al [18] achieved also a statistically significant improvement in VA.…”

Brilliant Blue Dyes in Daily Food: How Could Purinergic System Be Affected?

“…BBG should also be carefully studied in this context once it is currently used clinically in ophthalmic procedures [54, 55]. Surely, it is reasonable to consider that inflamed (mostly chronic) tissues would show P2X7R hyperactivity (directly or indirectly by pannexin-1) and that the ingestion of food containing blue dye could relieves or diminishes deleterious processes by P2X7R inhibition [43, 51, 56].…”

Foetal bovine serum can reduce toxicity of indocyanine green, brilliant blue G and trypan blue in ARPE‐19 cellular model that suggests new surgical staining protocols for internal limiting membrane peeling procedure

“…11,12 However its toxicity has also been reported including the facts that a high concentration will cause cell death, induce apoptosis and cause changes in the expression of cell cycle arrest genes. 15 BBG was firstly employed in ILM peeling procedure as part of a preclinical trial in 2006. 15 BBG was firstly employed in ILM peeling procedure as part of a preclinical trial in 2006.…”