Chromovitrectomy opens new frontiers in current vitreo-retinal surgery

Background: The intravitreal application of vital dyes has become popular to visualize preretinal structures,, chromovitrectomy". Methods: Indocyanine green (Pulsion), Trypan blue (Membrane blue, DORC) and Patent blue (Blueron, Gender) are approved for the ophthalmic use and are currently investigated for chromovitrectomy. Results: The intravitreal application of vital dyes was initially described more than 60 years ago to deterine retinal holes in detachment surgery. Today vital dyes have a new importance in, chromovitrectomy". The word, chromovitrectomy" was obtained from the established, chromoendoscopy" in gastroscopy. This technique uses also a variety of vital dyes to stain tissue of surgical interest. The novel dyeapplicator "Vitreoretinal -internal limiting membrane color enhancer (VINCE)" can apply vital dyes selectively on the retinal surface avoiding an additional staining of the peripheral retina in and within the macular hole itself. Conclusion: Although there is no doubt, that the application of vital dyes makes the surgical ILM-peeling much easier, possible toxic side-effects may occur after the intravitreal application of Indocyanine green. Further investigations are necessary, to determine which vital dye, in which concentration can be applied during chromovitrectomy avoiding any side-effect. The VINCE achieved a selective painting of the surgical essential structures, minimizing possible sideeffects.