Trypan blue-assisted peeling of the internal limiting membrane during macular hole surgery

Am J Ophthalmol. 2003 Jun;135(6):903-5. doi: 10.1016/s0002-9394(02)02239-0.


Purpose: To evaluate the outcome of surgeries for macular holes using trypan blue to facilitate delamination of the internal limiting membrane.

Design: A retrospective series of 18 patients.

Method: All patients underwent a three-port pars plana vitrectomy with internal limiting membrane delamination using trypan blue 0.06% to assist visualization. The main outcome measures were postoperative visual acuity and clinically evident retinal pigment epithelial changes.

Results: The median preoperative visual acuity was 20/200, and the median postoperative visual acuity was 20/70. All but one macular hole were closed after surgery (94%). At the last recorded follow-up, 10 patients (56%) had improved visual acuity of at least two chart lines. No adverse reaction related to trypan blue was observed up to 1 year postsurgery.

Conclusions: Trypan blue staining of internal limiting membrane may accomplish more complete dissections of the internal limiting membrane and better surgical and visual outcomes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Coloring Agents*
  • Epiretinal Membrane / diagnosis*
  • Epiretinal Membrane / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Staining and Labeling / methods
  • Trypan Blue*
  • Visual Acuity
  • Vitrectomy*


  • Coloring Agents
  • Trypan Blue