Ultrastructure and retinal imaging of epiretinal membrane: a clinicopathologic correlation of trypan blue staining in epiretinal membrane surgery.

PURPOSE: The purpose of this study was to correlate the ultrastructural morphology of epiretinal tissue with optical coherence tomography and to investigate the effects of trypan blue staining on epiretinal membrane (ERM) ultrastructure and clinical outcome. METHODS: A prospective, case-comparative study. Consecutive patients were recruited and underwent vitrectomy and ERM peeling with 0.15% trypan blue; these patients were compared with a control group peeled without stain. Optical coherence tomography was performed preoperatively and at 10 days and 3 months postoperatively. Data were collected prospectively to include Snellen visual acuity and surgical ERM characteristics. Epiretinal tissue was examined using transmission electron microscopy. RESULTS: Thirty-seven patients underwent ERM surgery, and 34 had complete data, of which 18 had peeling of unstained and 16 had peeling of stained ERM. Staining resulted in a significantly greater postoperative reduction in macular thickness compared with the unstained group. There was no significant difference in the visual outcome and no ultrastructural evidence of alteration of the cleavage plane in cases in which trypan blue was used. CONCLUSION: There was no clinical or ultrastructural evidence of toxicity in peeling with trypan blue.