Vital dyes for chromovitrectomy

• Main Authors: D. O. Shrvorchenko, S. V. Kolesnik, N. M. Kislitsina, S. A. Kakunina, K. S. Norman, A. I. Kolesnik, E. A. Krupina
• Format: Article
• Language: Russian
• Published: Publishing house "Ophthalmology" 2016-07-01
• Series: Офтальмохирургия
• Subjects: chromovitrectomy; vitreous body; epiretinal membrane; internal limiting membrane; vital dyes
• Online Access: https://www.ophthalmosurgery.ru/jour/article/view/258

One of the most difficult tasks for surgeons and one of the main components of success of surgical treatment is a safe removal of transparent vitreous body, and structures of the vitreoretinal interface (VI): translucent, internal limiting membrane (ILM), epiretinal membranes during subtotal vitrectomy. Biological and synthetic dyes are used for intra-operative visualization of vitreous body, highlighting its native structures and pathologically changed sites. The peak of development of the intravitreal injection of dyes was the appearance of a new surgical approach – chromovitrectomy, in 2000. Its essence consists in the injection of intraoperative dyes for contrast enhancement of structures of the posterior segment of the eye. This technique provides a better intra-operative visualization of vitreous body and the VI, a more thorough removal of the cortical vitreous layers, simplifies the peeling of ILM and epiretinal membranes, reducing the risk of iatrogenic damage to the retina. However, contrast agents have a number of side effects, and as a result, many discrepancies regarding the potential toxicity and safety of use of these substances remains. Despite the large accumulated in this field experience, a number of issues associated with the properties of intravitreal dyes, their interaction with the surrounding anatomical structures, side effects of these substances remain unresolved until now. It should provide adequate color difference between the stained ILM/ERM and the normal retina. Other favorable characteristics are: rapid elimination from vitreous cavity, photochemical stability, solubility in balanced salt solution, absence of toxicity and an adequate light absorption profile. Also, numerous dyes have been applied in experimental settings with promising or devastating results. This article highlights the major clinical and experimental results of currently used novel vital dyes. The aim of this article is to present the current state-of-theart in regard to the application of vital dyes during vitreoretinal surgery to overview the current literature regarding the properties of dyes, techniques of application, indications, and complications in chromovitrectomy, the surgical recommendations to minimize the risk of toxic effects.