Negative Effects of Vital Dyes After Uneventful Vitreomacular Surgery

Röhrig, Stephan; Farecki, Marie-Louise; Boden, Karl; Haus, Arno; Gutfleisch, Matthias; Jung, Sascha; Lommatzsch, Albrecht; Szurman, Peter; Januschowski, Kai

doi:10.1097/iae.0000000000002231

Cited by 5 publications

(9 citation statements)

References 21 publications

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“…Comparable postoperative findings have, to our knowledge, never been observed before the introduction of acid violet 17 into vitreoretinal surgery, or after withdrawal of the dye from the market. According to our knowledge, a similar observation after the use of this dye was only reported by Röhrig et al [5] in an eye after macular hole surgery. Since the dye was only on the market for a very short time, very few clinical reports are available on postoperative findings.…”

Section: Discussionsupporting

confidence: 83%

“…this mode of application is different from the label and the way primed by the delivered equipment in the dye package. Röhrig et al [5] retrospectively compared the outcome in patients after macular hole surgery with the use of either Membrane Blue-Dual (DORC, Zuidland, Netherlands) or ala purple. The authors observed an insignificant trend of worse average visual acuity, and more eyes with a postoperative loss of more than 2 lines in the acid violet 17 group.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term Follow-up of Acid Violet 17 Damage to the Retinal Pigment Epithelium and Retina after Macular Hole Surgery

Gerding

2024

Klin Monbl Augenheilkd

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Long-term Follow-up of Acid Violet 17 Damage to the Retinal Pigment Epithelium and Retina after Macular Hole Surgery

Gerding

2024

Klin Monbl Augenheilkd

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“…In general, the use of vital dyes in vitreoretinal surgery is very common and represents an important tool during the surgical procedure. Vital dyes, for their defined mechanism of action, are not supposed to damage the stained cells, however, in the past, some concerns about potential retinal toxicity has been raised (Röhrig et al, 2019). Awareness about vital dyes safety was mainly related to dye uptake and retention in retinal layers, underneath to the ILM (Cheng et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

New Brilliant Blue G Derivative as Pharmacological Tool in Retinal Surgery

et al. 2020

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Our study was aimed at assessing the retinal binding of a new synthetic Brilliant Blue G (BBG) derivative (pure benzyl-Brilliant Blue G; PBB) ophthalmic formulation, to improve vitreoretinal surgery procedure. Protein affinity of the new molecule was evaluated in vitro (cell-free assay) and in silico. Furthermore, an ex vivo model of vitreoretinal surgery was developed by using porcine eyes to assess the pharmacological profile of PBB, compared to commercial formulations based on BBG and methyl-BBG (Me-BBG). PBB showed a higher affinity for proteins (p < 0.05), compared to BBG and Me-BBG. In vitro and in silico studies demonstrated that the high selectivity of PBB could be related to high lipophilicity and binding affinity to fibronectin, the main component of the retinal internal limiting membrane (ILM). The PBB staining capabilities were evaluated in porcine eyes in comparison with BBG and Me-BBG. Forty microliters of each formulation were slowly placed over the retinal surface and removed after 30 s. After that, ILM peeling was carried out, and the retina collected. BBG, Me-BBG, and PBB quantification in ILM and retina tissues was carried out by HPLC analysis. PBB levels in the ILM were significantly (p < 0.05) higher compared to BBG and Me-BBG formulations. On the contrary, PBB showed a much lower (p < 0.05) distribution in retina (52 ng/mg tissue) compared to BBG and Me-BBG, in particular PBB levels were significantly (p < 0.05) lower. Therefore, the new synthetic Brilliant Blue derivative (PBB) showed a great ILM selectivity in comparison to underneath retinal layers. In conclusion, these findings had high translational impact with a tangible improving in ex vivo model of retinal surgery, suggesting a future use during surgical practice.

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“…The limitations of our study are the small sample size and a relatively short follow-up time, which may have led to insufficient statistical analysis. Recently it has been shown that a sample size of more than 1000 would be required to detect subtle negative effects of a vital dye [29]. However, it is in the best interest of vitreoretinal surgeons to have real life safety data early on to improve patient safety.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Macular Function Following Internal Limiting Membrane Peeling With ILM Blue

Rickmann¹,

Al-Nawaiseh²,

Volpe³

et al. 2020

Cureus

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To evaluate clinical outcome after surgery of idiopathic epiretinal membranes (ERM) with internal limiting membrane (ILM) peeling using a commercial combination of Brilliant blue G (BBG, 0.25 mg/ml) with 4% polyethylene glycol (PEG). Methods It was a prospective, single-center study. Macular surgery was performed due to ERM (n = 18) by two experienced surgeons. Exclusion criteria were secondary ERM, previous retinal surgery and pharmacological treatment. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and multifocal ERG (RETIscan) were assessed at baseline and three months after surgery. Results The BCVA improved from baseline 0.4 ± 0.13 logMAR to 0.3 ± 0.2 logMAR after three months (p > 0.05). The mean central foveal thickness was reduced from 407 ± 85 μm to 366 ± 56 μm after three months (p > 0.05). At baseline, the mean P1 amplitude (nV/deg 2) was 53.5 ± 32.1 in ring 1 and 35.9 ± 20.1 in ring 2. Three months after surgery the mean P1 amplitude was comparable with 57.2 ± 16.3 in ring 1 and 38.0 ± 11.7 in ring 2 compared with the initial situation (p = 0.22 and p = 0.3, respectively). Conclusion BBG with 4% PEG can be used for ILM peeling in patients with idiopathic epiretinal membranes without any sign of short-term toxicity.

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Negative Effects of Vital Dyes After Uneventful Vitreomacular Surgery

Abstract: Our rather homogeneous study showed no significant difference between both dyes. Thousand five hundred patients would need to be examined to find a significant difference in future studies.

Cited by 5 publications

References 21 publications

Long-term Follow-up of Acid Violet 17 Damage to the Retinal Pigment Epithelium and Retina after Macular Hole Surgery

Long-term Follow-up of Acid Violet 17 Damage to the Retinal Pigment Epithelium and Retina after Macular Hole Surgery

New Brilliant Blue G Derivative as Pharmacological Tool in Retinal Surgery

Assessment of Macular Function Following Internal Limiting Membrane Peeling With ILM Blue

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