Trypan blue-assisted peeling of the internal limiting membrane during macular hole surgery

Abstract

Purpose: To evaluate the outcome of surgeries for macular holes using trypan blue to facilitate delamination of the internal limiting membrane.

Design: A retrospective series of 18 patients.

Method: All patients underwent a three-port pars plana vitrectomy with internal limiting membrane delamination using trypan blue 0.06% to assist visualization. The main outcome measures were postoperative visual acuity and clinically evident retinal pigment epithelial changes.

Results: The median preoperative visual acuity was 20/200, and the median postoperative visual acuity was 20/70. All but one macular hole were closed after surgery (94%). At the last recorded follow-up, 10 patients (56%) had improved visual acuity of at least two chart lines. No adverse reaction related to trypan blue was observed up to 1 year postsurgery.

Conclusions: Trypan blue staining of internal limiting membrane may accomplish more complete dissections of the internal limiting membrane and better surgical and visual outcomes.