November 01, 2013
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Brilliant blue G shows internal limiting membrane after epiretinal membrane peel

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Internal limiting membrane commonly remains after epiretinal membrane peeling, according to a study.

The study authors suggested that re-staining with brilliant blue G (BBG) and peeling again may help remove the entire epiretinal membrane (ERM).

The prospective study included 98 eyes that underwent pars plana vitrectomy and membrane peeling for idiopathic ERM. BBG was injected into the vitreous cavity and promptly washed out. The surgeon peeled the ERM and observed the underlying internal limiting membrane (ILM).

The posterior pole was re-stained with BBG, and the ILM was observed again. The rest of the ILM was then peeled.

All eyes had residual ILM after an initial ERM peel. Fragments of ILM were present and damaged in 74 eyes and present and undamaged in 24 eyes.

The ILM was believed to be removed after the peel in 21 eyes. However, BBG staining showed the ILM was present in all 21 eyes.

Mean best corrected visual acuity improved significantly from 0.75 at baseline to 0.31 at 6 months (P < .0001).

Central macular thickness improved from 460 µm at baseline to 297 µm at 6 months (P < .003).

Disclosure: The study authors have no relevant financial disclosures.

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