Historical Aspects and Evolution of the Application of Vital Dyes in Vitreoretinal Surgery and Chromovitrectomy

Abstract

Lobeck and coworkers performed the first intravitreal application of vital dyes to visualize preretinal structures in 1932. Since then numerous investigators in the 20th century examined the use of biological stains through the endovenous, subretinal and intravitreal delivery route in order to identify vitreoretinal tissues and breaks. However, in the year 2000, a new surgical approach, recently coined chromovitrectomy, has arisen, which consists in the intraoperative application of vital dyes during vitrectomy. Initially fluorescein, and more recently indocyanine green, trypan blue, bromophenol blue, triamcinolone acetonide and patent blue have been used for the staining of preretinal membranes and tissues. Currently, many vital stains are under evaluation in animals for future clinical application during chromovitrectomy such as indigo carmine or light green. In this paper, several historical considerations in regard to the application of vital dyes in chromovitrectomy are discussed.