Chromodissection in vitreoretinal surgery

Abstract

The term chromodissection refers to the use of staining substances at the vitreoretinal interface during ophthalmic surgery to improve visualization of otherwise transparent and barely detectable structures, predominantly the internal limiting membrane (ILM) of the retina [1]. Today, several dyes such as indocyanine green (ICG), brilliant blue (BB), or trypan blue (TB) are in use to selectively stain the ILM and premacular membranes. Beyond a better visualization of the target structure, little is known about other effects as a result of the interaction between the dye and the stained tissue. There is some evidence that ILM dyes interfere with the mechanical properties of the ILM in a variable fashion, and toxic effects, especially for ICG, have been reported leading to less favorable functional results of the surgical procedure. While the search for alternative dyes is ongoing, it is important to use these adjuncts with care and take into account the different modes of application, exposure times, and concentrations in the absence of a standardized protocol.