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Comparison of 3 different formulations of brilliant blue G dye with indocyanine green dye and trypan blue dye for ILM staining in macular hole surgery

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 08:16

Venue: Boulevard E

First Author: : C.Gupta INDIA

Co Author(s): :    C. Shroff   P. Gupta   D. Shroff   N. Atri     

Abstract Details

Purpose:

To assess the safety and efficacy of 3 different formulations Brilliant Blue G dye - Ocublue Plus, ILM BLUE, Brilliant Peel for ILM staining in Macular Hole Surgery and to compare it to the earlier used dyes – Indocyanine Green and Trypan Blue.

Setting:

Retrospective interventional case study conducted at a tertiary care centre .

Methods:

Retrospective analysis of 171 eyes of Idiopathic macular hole who underwent vitrectomy with dye assisted ILM peeling and gas tamponade . Cataract extraction was combined with vitrectomy when cataract was significant. 24 eyes underwent ILM peeling with Indocyanine Green – Group 1, 66 eyes with Trypan Blue – Group 2, 31 eyes with Ocublue Plus (BBG 0.05%) – Group 3, 32 eyes with ILM BLUE (BBG 0.025% + 4% PEG) – Group 4, 18 eyes with Brilliant Peel (BBG 0.025% + Deuterium Oxide) – Group 5. Pre and Post operative Best Corrected Visual Acuity (BCVA), Lens status assessment and OCT were done for all patients. Patients were followed up at baseline, 6 weeks, 3 months and 6 months. Minimum follow up of 3 months was mandatory.

Results:

All 5 groups were well matched in demographic data, baseline visual acuity and percentage of eyes undergoing simultaneous cataract extraction. Macular hole was closed in 97.7% of eyes. Mean pre and post operative logMAR BCVA was 0.90 and 0.44 in ICG group; 0.87 and 0.38 in the Trypan Blue group; 0.842 and 0.45 in the Ocublue Plus group; 0.881 and 0.44 in the ILM BLUE group and 0.878 and 0.50 in the Brilliant Peel group respectively. Postoperatively, BCVA improved or was same in all patients in Trypan Blue and Brilliant Peel groups but deterioration was seen in 2 eyes each in ICG and Ocublue Plus groups and in 1 eye in ILM BLUE group. Post operatively, 20/200 or better BCVA was seen in all eyes in ICG and Trypan Blue groups and in 93.7%, 96.9%, 94.4% of eyes in Ocublue Plus, ILM BLUE, Brilliant Peel groups respectively. BCVA of 20/40 or better was seen in 41.7%, 54.5%, 51.6%,50%,50% of eyes in ICG, Trypan Blue, Ocublue Plus, ILM BLUE, Brilliant Peel groups respectively. No significant postoperative complication like retinal detachment was seen.

Conclusions:

All groups showed a good closure rate with minimal complications.There was no statistically significant difference in the anatomical and functional outcome between all the 5 groups (P= 0.329). All the 3 different formulations of Brilliant Blue G stained ILM well, showed a good safety and efficacy profile and compared favourably to the earlier used dyes – Indocyanine Green and Trypan Blue.

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