Brilliant blue G dye safe for ILM peeling in macular hole surgery, study says

Indian J Ophthalmology.2011;59(2):158-160.

Performing internal limiting membrane peeling with brilliant blue G dye resulted in the complete removal of the membrane and closure of all macular holes without causing toxicity, a study found.

The study included six eyes of six patients who underwent 23-gauge pars plana vitrectomy with brilliant blue G-assisted internal limiting membrane peeling. All patients had macular holes larger than 400 µm preoperatively.

One week after the procedure, all macular holes were completely closed in all patients and remained closed for the 20-week follow-up period, according to the study.

The mean logMAR visual acuity showed a statistically significant improvement from 0.11 before surgery to 0.23 at the last follow-up visit (P = .0325). Researchers did not observe any ocular or systemic side effects.

Visual field defects can result from dye toxicity, but none were detected in any of the study patients. In addition, red-free photographs showed no evidence of abnormalities in the retinal pigment epithelium or the nerve fiber layer during the follow-up period.

The authors concluded that the low potential toxicity of brilliant blue G could make it safer than trypan blue or indocyanine green during macular hole surgery. However, larger studies cannot be conducted until brilliant blue G is more readily available to vitreoretinal surgeons in India, they said.