Double Visualization Using Triamcinolone Acetonide and Trypan Blue during Stage 3 Macular Hole Surgery

Vol. 218, No. 5, 2004

Free Abstract Article (Fulltext) Article (PDF 442 KB)

Original Paper

Double Visualization Using Triamcinolone Acetonide and Trypan Blue during Stage 3 Macular Hole Surgery
Narumichi Yamamoto, Noriko Ozaki, Kimio Murakami

Department of Ophthalmology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

Address of Corresponding Author

Ophthalmologica 2004;218:297-305 (DOI: 10.1159/000079470)

Key Words

Macular hole
Pars plana vitrectomy
Posterior vitreous cortex
Triamcinolone acetonide
Premacular vitreous cortex
Trypan blue
Internal limiting membrane

Abstract

Purpose: To study the usefulness of intravitreal injection of triamcinolone acetonide and trypan blue for facilitating visualization and dissection of the posterior vitreous cortex and internal limiting membrane (ILM) during vitrectomy in idiopathic stage 3 macular holes. Methods: Pars plana vitrectomy was performed in 10 eyes of 10 patientswith idiopathic stage 3 macular holes. After core vitrectomy had been performed, triamcinolone acetonide was injected over the posterior pole. After separation of the visualized posterior vitreous cortex, trypan blue was injected over the macular area. Excised specimens were examined by electron microscopy. Results: Upon injection of triamcinolone acetonide, the posterior vitreous cortex and residual vitreous cortex could be visualized in all patients. The posterior vitreous cortex and residual vitreous cortex were completely removed. The ILM of the retina was stained faint blue and was successfully removed in all patients. Electron microscopy revealed that the triamcinolone-acetonide-visualized layer and the trypan-blue-stained layer had different histological features. No complications related to the use of triamcinolone acetonide and trypan blue were encountered. Conclusion: Double visualization of the posterior vitreous cortex and ILM using triamcinolone acetonide and trypan blue during vitrectomy may facilitate separation of the posterior vitreous cortex from the retina and removal of the ILM around the macular hole in patients withidiopathic stage 3 macular holes.

Author Contacts

Narumichi Yamamoto, MD
Department of Ophthalmology, Tokyo Metropolitan Komagome Hospital
3-18-22 Honkomagome Bunkyo-ku
Tokyo 113-8677 (Japan)
Tel. +81 3 3823 2101, Fax +81 3 3824 1552, E-Mail naruy@cick.jp

Article Information

Received: November 5, 2003
Accepted after revision: March 25, 2004
Number of Print Pages : 9
Number of Figures : 3, Number of Tables : 1, Number of References : 33

Medline Abstract (ID 15334009)

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