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Staining mandatory for safe, accurate ILM peeling
 Yannick Le Mer |
LONDON — Staining is mandatory for thorough, safe, easy internal limiting membrane removal, according to one speaker here.
"It is easier to remove something you see rather than something that is supposed to be there," Yannick Le Mer, MD, said at the Euretina meeting.
Among dyes, brilliant blue specifically stains the internal limiting membrane (ILM), is the only dye to have obtained CE mark for this indication, and is nontoxic and widely used in the food industry.
In a prospective study, 70 patients were operated for various macular diseases and had ILM peeling performed without staining. At the end of surgery, brilliant blue dye was used to stain the area and assess the quality of dissection.
"In 38% of the cases, ILM peeling was only partial and we had to peel again. In 20% of the cases, it was sufficient, but there were residuals that we preferred to remove to have a properly cleaned area," Dr. Le Mer said.
Without staining, complications were more common. In 33% of the eyes, either retinal pinches or localized superficial hemorrhages occurred.
"Staining is the only way to assess peeling quality and safety while you do your maneuvers. The little additional time you spend delivering and removing the dye is regained by faster dissection. The only drawback of brilliant blue is cost, but it is the only dye that allows you to avoid kitchen pharmacy and problems with phototoxicity," Dr. Le Mer said.
- Disclosure: Dr. Le Mer has no relevant financial disclosures.
