Combined Brilliant and Trypan Blue As a Vital Dye for Chromovitrectomy Authors:

Bruno Fortaleza de Aquino Ferreira - bruno.fortaleza@fm.usp.br - https://orcid.org/0000-0003-3555-9122

Gustavo Sakuno - gustavo@sakuno.com.br - https://orcid.org/0000-0001-6485-1742

Juliana Mika Kato - juliana.kato@alumni.usp.br - https://orcid.org/0000-0002-1815-4644

Rodolfo Bonatti - rodolfobonatti@gmail.com - https://orcid.org/0000-0001-9912-2582

Álvaro Fernandes Ferreira - dralvaro85@gmail.com

Aloisio Fumio Nakashima - alonakashima@gmail.com

Yoshitaka Nakashima - yoshitaka@globo.com

Abstract:

Brilliant blue 0.05% and trypan blue 0.1% were mixed in a proportion of 1:1 in a 1-mL syringe. This combination produced a waterfall effect with the fast sinking of the dye to the posterior pole and little diffusion through the vitreous cavity. Therefore, it can effectively stain the internal limiting membrane and the epiretinal membrane with a good contrast during surgeries for a macular hole, myopic foveoschisis, and macular pucker.

References:

1. Enaida H, Hisatomi T, Nakao S, Ikeda Y, Yoshida S, Ishibashi T. Chromovitrectomy and vital dyes. Dev Ophthalmol 2014;54:120–125.

2. Awad D, Schrader I, Bartok M, Sudumbrekar N, Mohr A, Gabel D. Brilliant Blue G as protective agent against trypan blue toxicity in human retinal pigment epithelial cells in vitro. Graefes Arch Clin Exp Ophthalmol. 2013;251:1735– 1740.

3. Awad D, Schrader I, Bartok M, Mohr A, Gabel D. Comparative toxicology of trypan blue, brilliant blue G, and their combination together with polyethylene glycol on human pigment epithelial cells. Invest Ophthalmol Vis Sci 2011.

4. Mohr A, Bruinsma M, Oellerich S, Frank H, Gabel D, Melles GR, et al. Dyes for EyesTM: Hydrodynamics, biocompatibility and efficacy of ’heavy’ (dual) dyes for chromovitrectomy. Ophthalmologica 2013;230:51–58.

5. Veckeneer M, Mohr A, Alharthi E, Azad R, Bashshur ZF, Bertelli E et al. Novel ’heavy’ dyes for retinal membrane staining during macular surgery: Multicenter clinical assessment. Acta Ophthalmol 2014;92:339–344.

6. Willermain F, Libert S, Motulsky E, Salik D, Caspers L, Perret J, et al. Origins and consequences of hyperosmolar stress in retinal pigmented epithelial cells. Front Physiol 2014 30;5:199.

7. Tognetto D, Giacinto CD, D’Aloisio R, Papagno C, Pastore M, Zweyer M. ”The combination of trypan blue and brilliant blue G-assisted vitrectomy for macular pucker: Histopathological findings.” Ophthalmologica 2018;239:167–175.

8. Maia M, Prazeres JMB, Farah ME, Rodrigues E, Maia A. Cromovitrectomia. e-Oftalmo.CBO: RevDig Oftalmol 2015;1:1–18.