Trypan Blue Assisted Epiretinal Membrane Removal in Pars Plana Vitrectomy

Purpose: To report the results of using trypan blue 0.15% in staining epiretinal membrane (ERM) to facilitate its removal during pars plana vitrectomy (PPV). Material-Methods: Fourteen eyes of 14 patients (mean age 67 years, 8 women and 6 men) with idiopathic ERM underwent PPV. Following core vitrectomy and air fluid exchange, 0.15% trypan blue solution was used to stain ERM. Trypan blue was washed from intravitreal cavity after few minutes. In cases in which staining is not sufficient, the same protocol was repeated. ERM removal could be facilitated by staining the borders with trypan blue. Anatomic results were evaluated with optical coherence tomography and functional results were evaluated by using Snellen visual acuity chart. LogMAR visual acuity equivalents were used for statistical analysis. Results: Mean follow-up time was 6 months (range, 3-12 month). Postoperatively, 10 of 14 eyes (71%) with ERM had a visual improvement of two or more Snellen lines while in an eye no visual improvement was noted. Visual acuity decreased in 3 of 14 eyes (21%). Postoperative visual acuity at final examination (0.40 +/- 0.08, mean +/- SEM) was insignificantly higher than preoperative visual acuity (0.22 +/- 0.04, P= 0.073, Wilcoxon signed rank test). A patient underwent facoemulsification and PPV at the same session. SF6 gas was used in two eyes, C3F8 was used in four eyes and air was used in eight eyes as an intravitreal tamponade. The borders of ERM were clearly visible following trypan blue staining in all eyes. We experienced no manifest complication from trypan blue during and after the operation. During postoperative examinations cataract was detected in four eyes and two of them underwent cataract extraction. Conclusion: In vitreoretinal surgery, trypan blue staining facilitates not only visibility of ERM but also its complete removal.