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Year : 2011  |  Volume : 10  |  Issue : 1  |  Page : 10-13

New vital dyes to stain intraocular membranes and tissues during vitrectomy

Vision Institute, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil

Correspondence Address:
MD PhD Mauricio Maia
901 Otto Ribeiro Assis, SP
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Source of Support: None, Conflict of Interest: None

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Purpose: 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. Design: Critical analysis and surgical perspective of the literature, recent studies and personal contributions. Methods: Review, interpretation, and comments regarding the most relevant experimental as well as clinical studies including the authors' clinical and laboratory research. Results: The evolution of vitreoretinal surgical techniques has been worldwide reported. Chromovitrectomy plays an important hole in these innovations and is very useful to improve the surgical results. There is a consensus that 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. 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. The indocyanine green may be toxic for the retinal pigment epithelium if subretinal migration occurs during the surgical procedure. Efforts to avoid subretinal migration of dyes are very important during macular hole surgery. The physiological osmolarity around 270-320mOsm as well as ideal concentrations of the vital dyes during vitreoretinal surgery are important subjects. Conclusions: The state-of-the-art staining-assisted procedures should be performed using concentrations and volumes as low as possible. Triamcinolone acetonide is the ideal dye for vitreous; indocyanine green, infracyanine green and brilliant blue are the ideal dyes for internal limiting membrane; trypan blue is the ideal dye for epiretinal membrane identification.

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