Lutein-based dye vitrectomy for idiopathic epiretinal membrane: a pilot study

Introduction: The use of vital dyes is essential for enhancing visualization of the vitreous and vitreoretinal interface during surgery. In this study, we evaluated the efficacy of a new lutein-based vital dye (LB-VD) for selective staining of the vitreous body and posterior hyaloid in patients undergoing 25 G vitrectomy for idiopathic epiretinal membrane (ERM). Methods: A total of 18 patients who underwent ERM surgery assisted by LB-VD were retrospectively analyzed. The surgeon completed a postoperative satisfaction questionnaire to evaluate the vitreous staining. Data on best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), and fixation stability were collected at baseline and at 4 and 6 months post-surgery. Results: LB-VD effectively stained the vitreous body and posterior hyaloid, facilitating key surgical maneuvers. Significant improvements were observed in BCVA and CRT at both 4 and 6 months post-surgery. Specifically, BCVA improved from 0.60 ± 0.29 LogMAR at baseline to 0.33 ± 0.26 LogMAR at 4 months (p = 0.004) and to 0.32 ± 0.25 LogMAR at 6 months (p = 0.003). CRT decreased significantly from 429 (375–499) μm at baseline to 335 (254–375) μm at 4 months (p = 0.03) and to 323 (240–356) μm at 6 months (p = 0.01). Fixation stability improved in approximately 95% of patients by 6 months. No significant changes in IOP were noted. Discussion: LB-VD provided clear visualization of the vitreous body and posterior hyaloid, thereby facilitating key vitreoretinal surgical tasks. These findings suggest that LB-VD is an effective and safe alternative to traditional dyes currently used in vitreoretinal surgery.