Vitreoretinal surgery using bromphenol blue as a vital stain: evaluation of staining characteristics in humans

Objective: To evaluate the staining characteristics of bromphenol
blue used during vitreoretinal surgery in humans.Patients and
methods: 13 patients with epiretinal membranes were included.
Before and after surgery a complete clinical examination including
best corrected visual acuity, funduscopy, fluorescein angiography,
OCT (Stratus), Goldmann perimetry and multifocal ERG as well as
photography of the macular area was performed. Bromphenol blue was
used in concentrations of 0.2% in most patients. Removed epiretinal
tissue was evaluated using electron microscopy.Results: Using dye
concentrations of 0.2% a good demarcation of epiretinal membranes
was seen in 11/13 patients. Staining of vitreous remnants at the
vitreous base was seen in all patients. No dye-related adverse
events were seen during follow-up in the functional tests (VA, ERG,
perimetry) performed. Histological evaluation of epiretinal
membranes showed unremarkable aspects of epiretinal cellular layers
and unremarkable retinal surface of the internal limiting membrane
(ILM).Conclusion: Bromphenol blue appears to be a very helpful and
safe tool in posterior segment surgery. The staining
characteristics need to be further evaluated in prospective study
settings and larger numbers of patients.