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How it appears: electron microscopic evaluation of internal limiting membrane specimens obtained during brilliant blue G assisted macular hole surgery

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Keywords
  • Medizin
  • Ddc:610
Disciplines
  • Agricultural Science
  • Biology
  • Medicine

Abstract

How it appears: electron microscopic evaluation of internal limiting membrane specimens obtained during brilliant blue G assisted macular hole surgery How it appears: electron microscopic evaluation of internal limiting membrane specimens obtained during brilliant blue G assisted macular hole surgery The intravitreal application of the novel dye, brilliant blue G (BBG), has recently been suggested to facilitate macular hole and epiretinal membrane surgery because BBG has been shown to selectively stain the internal limiting membrane (ILM).1 Several advantages compared with other dyes such as indocya- nine green or trypan blue have been reported.2 In particular, BBG did not show apoptotic death of retinal cells as it was found in laboratory investigations on indocyanine green and trypan blue.3 4 To determine if there are any pathological changes in the ILM and adherent structures or apparent damage to the retina, we analysed surgical specimens of BBG assisted ILM peeling in macular hole surgery using electron microscopy. Nine eyes from nine patients (six women, three men) presented with full thickness macular holes and underwent standard three port pars plana vitrectomy with induction of a posterior vitreous detachment by suction with the vitrectomy probe around the optic nerve head. A sterile 0.2 mg/ml BBG solution (Fluoron GmbH, Neu-Ulm, Germany) was injected into the fluid filled vitreous cavity over the macular area and washed out by irrigation immediately. The ILM was then removed using an end gripping forceps. Preoperative and postoperative ophthalmic examinations included slit lamp microscopy, ophthalmoscopy, best corrected visual acuity, intraocular pressure and optical coherence tomography. Excised specimens from all eyes were immediately placed into phosphate buffered 4% glutaraldehyde solution for fixation. Postfixation in osmium tetroxide 2% (Dalton’s fixative), dehydration in graded concentrations of ethanol and embedding in Epon 812 followed. Ultrathin sections of 60 nm

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