Coumassie Blue or Brilliant Blue G (BBG) has been introduced as a surgical adjuvant for chromovitrectomy in 2006. This dye was reported to stain the ILM and to have no significant in vivo toxicity. In contrast Triamcinolone Acetonide produces a better vitreous visibility, the crystals of the steroid adhere to the acellular tissue, thereby enabling a clear contrast between the empty vitreous cavity compared to areas with the vitreous fibers remaining.

During macular hole surgery or epiretinal membrane peeling, we observed  that BBG injected after core vitrectomy  tremendously helped visualization of  vitreoretinal junction around cortical vitreous and bursa premacularis whereas It did not stain  at all the ILM at the fovea if posterior vitreous was still attached. Once posterior vitreous is detached BBG easily covers and stains the ILM at the surface of the macula. In this situation it can also be easily removed passively by flute needle.

So we used BBG just after core vitrectomy to demostrate the status of vitreous, enhance vitreous retinal interface visualization and just after vitreous separation to stain the ILM.

Contact Details:

Jean Paul Berrod