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Dye-ing to do vitrectomy

The talk presented at OEU Alumni meet 2012

Dr. Biju Raju

on 27 May 2016

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Transcript of Dye-ing to do vitrectomy

Traverses the cell membranes and stains ERM
Does not stain ILM well
Ideal use:
To demarcate the exact extent of ERM Trypan Blue TA particles get suspended within the vitreous collagen fibrils
Settles on ERM / ILM – enhancing the visibility
Ideal use:
PVD induction
ERM peel
ILM peeling Triamcinolone Acetonide Dyes for Vitrectomy – a time line Difficulty to visualize the vitreous, ILM and ERM The Problem Brilliant blue
Bromphenol Blue
Fluoromethalone Acetate (FMA)
Infracyanine C Other Dyes Has high affinity to ECM of ILM
Stains ILM selectively
Ideal use
ILM peeling in Macular hole surgery Indocyanine Green (ICG) Sodium Fluorescein Biju Raju
MS (OEU/IO, KMC Manipal),
Fellow of National Board (Vitreoretinal Diseases)
Fellow of LVPEI (Vitreoretinal Surgery)
Ranjini Eye Hospital
Cochin Dye-ing to do Vitrectomy Transparent and invisible
Incomplete removal
Gliosis, retinal breaks and phototoxicity Staining of vitreous, ERM and ILM
Improve visualization
Complete removal of membranes
Enhanced outcomes Chromovitrectomy The Solution Chromovitrectomy Safe
No toxicity to retina
Stains vitreous well
Ideal use
Peripheral Vitreous removal Infracyanine Green
Trypan Blue 2003 Sodium Fluorescein 1970 Triamcinolone acetonide Indocyanine Green 2000 Brilliant blue
Bromphenol blue 2005 Application of dyes during retinal surgery to visualize retinal / preretinal membranes and tissues Double Dye Enhanced Vitrectomy Summary TA - PVD induction
ICG / Brilliant blue - ILM
Trypan blue - ERM
Fluorescein - peripheral vitreous THANK YOU Thank you Abrams GW, Topping T, Machemer R.
An improved method for practice vitrectomy
Arch Ophthalmol 1978 Dose dependent toxicity of ICG Muller cells
Photoreceptors Osmolar
pH mediated
Phototoxicity Possible hypotheses Das T, Parida S, Majji AB.
Does Internal Limiting Membrane Peeling in Macular Hole Surgery Improve Reading Vision?
Indian J Ophthalmol 2003 No Sodium Iodine in IfCG
Iodine - toxicity
Sodium - osmolarity related toxicity Infracyanine Green (IfCG) No toxicity when compared with ICG
Excellent affinity to ILM Brilliant Blue Non toxic
Clinical trials awaited Bromphenol B Synthetic Fluorinated glucocorticosteroid
An alternative to TA
Clinical trials awaited FMA
Full transcript