J Korean Ophthalmol Soc.  2015 Jul;56(7):1044-1050. 10.3341/jkos.2015.56.7.1044.

Internal Limiting Membrane Peeling Using 0.025% Brilliant Blue G During Vitrectomy

• Choi BS
• Shin MK
• Park SW
• Byon IS
• Lee JE
• Oum BS

• KMID: 2148804
• DOI: http://doi.org/10.3341/jkos.2015.56.7.1044

Abstract

PURPOSE
To evaluate 0.025% brilliant blue G (BBG) for staining the internal limiting membrane (ILM) during vitrectomy.
METHODS
In a retrospective, non-comparative clinical case series, we analyzed consecutive 111 patients who underwent pars plana vitrectomy and removal of the ILM after staining using BBG solution. BBG was dissolved and diluted with balanced salt solution at a concentration of 0.025% and then sterilized by filtering through a 0.22 microm millipore filter. The prepared BBG solution was injected into the vitreous cavity over the macula after removal of the vitreous and excessive solution was removed immediately.
RESULTS
The ILM was successfully removed without use of additional adjuvant in all cases. Mean best corrected visual acuity (log MAR) was significantly improved from 0.80 +/- 0.44 at baseline to 0.40 +/- 0.39 at 6 months postoperatively (p < 0.001). One case each of endophthalmitis and diabetic papillopathy developed. The relationship when using BBG solution was not identified as complications were not observed in the other patients who underwent vitrectomy using the same BBG solution on the same day. One idiopathic epiretinal membrane patient had visual acuity loss more than 2 lines. During the follow-up period, other complications suspected to be associated with the use of BBG solution were not observed.
CONCLUSIONS
A BBG solution (0.025%) was effective in staining the ILM for removal. Complications associated with the use of BBG solution were not observed.

Keyword

Brilliant blue G; Internal limiting membrane

MeSH Terms

Endophthalmitis
Epiretinal Membrane
Follow-Up Studies
Humans
Membranes*
Micropore Filters
Retrospective Studies
Visual Acuity
Vitrectomy*

Figure

• 

  Figure 1. Intraoperative view of using 0.025% Brilliant Blue G (BBG). (A) During injection of 0.025% BBG for internal limiting membrane (ILM) stain. (B) ILM was stained well enough to remove safely using intraocular forcep.

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  Figure 2. Mean best corrected visual acuity (log MAR) after vitrectomy and removal of the internal limiting membrane using brilliant blue G solution. Visual acuity improved significantly at 3 and 6 months. log MAR = logarithm of the minimum angle of resolution; BCVA = best corrected visual acuity; Preop = preoperation. *p < 0.05, wilcoxon signed rank test.

• 

  Figure 3. Visual acuity changes after operation.

Reference

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