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Abstract
To present the current state-of-the-art information regarding the properties, indications,
surgical techniques, and toxic effects of current and past applications of vital dyes
in chromovitrectomy.
Critical analysis and surgical perspective of the literature and recent studies.
Review, interpretation, and commentary regarding the most relevant experimental as
well as clinical studies including the authors' clinical and laboratory research.
There is a consensus that the application of vital dyes facilitates the delicate removal
of intraocular membranes during vitreoretinal surgery. Controversy still remains around
various issues, mainly potential toxicity and safety. There is room for further investigation
of novel and specific vital dyes. Dyes such as Evans blue and light green may stain
the internal limiting membrane very well, whereas fast green and indigo carmine may
be very safe to the retina. However, comparing the staining and toxicity data has
revealed that Bromophenol blue and Brilliant blue may be even better novel agents.
The dyes currently used for different steps in chromovitrectomy are: triamcinolone
acetonide for vitreous identification; indocyanine green, infracyanine green, and
Brilliant blue for internal limiting membrane identification; and Trypan blue for
epiretinal membrane identification.
Clear-cut safety profiles for the different dyes in chromovitrectomy have not yet
been established, and current state-of-the-art staining-assisted procedures should
be performed using concentrations and volumes as low as possible.