New application of membrane blue-dual dye for retinal or iatrogenic break staining in retinal detachment surgery
Papavasileiou, E.
Hellenic Journal of Nuclear Medicine 22(Suppl 2): 63-70
2019
ISSN/ISBN: 1790-5427 PMID: 31802047 Document Number: 698102
The principles of surgery for managing primary rhegmatogenous retinal detachment (RRD) are to precisely identify and correctly treat all causative retinal breaks. Estimates regarding unidentified breaks complicating RRDs vary from 2.2%-22.5%. To evaluate the efficacy of membrane blue-dual heavy dye solution for staining of undetected preoperatively retinal and iatrogenic breaks. 1. This is a prospective interventional study. 23 and 27-gauge vitrectomy surgeries were evaluated for primary repair of 5 patients with rhegmatogenous retinal detachment (RRD). No breaks where identified prior to surgery despite meticulous pre-operative examination using binocular indirect ophthalmoscopy with indentation. 0.1ml of MembraneBlue-Dual™ was applied onto the vitreous cavity, while it was completely filled with fluid, and all excess dye was immediately aspirated with a blunt backflush instrument. In all eyes with RRD, the surgery was completed by gas tamponade (C3F8 or SF6). Follow up was 6 months. We compared the number of breaks identified when examined intraoperative with internal peripheral indentation before and after injection of the dye and found that in all cases (100%) at least one more break was found after injection of dye which was subsequently treated with cryotherapy or endolaser. At last follow up six months after surgery the success rate was 100% and none of our cases re-detached. The greatest advantage of use of this "heavy" dye solution membrane blue-dual is improved intraoperative identification of ILM at the edges of retinal breaks and the discrimination of them from surrounding intraocular structures. Due to its increased molecular weight and viscosity properties it eliminates the need for fluid-air exchange, injection of PFCL or subretinal injection.