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

Settimio Rossi¹Carlo Gesualdo^1*Michele Della Corte¹Antonio Del Giudice¹Andrea Rosolia¹Maria Consiglia Trotta²Francesca Simonelli¹

• ¹Dipartimento Multidisciplinare di Specialità Medico-Chirurgiche e Odontoiatriche, Università della Campania Luigi Vanvitelli, Naples, Italy
• ²Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Campania, Italy

The use of vital dyes is crucial to improve the visualization of vitreous and vitreoretinal interface during surgery. Here 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: 18 patients who underwent ERM surgery assisted by LB-VD were retrospectively analyzed. The surgeon completed a post-operative 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, 4 months, 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 after surgery. Specifically, BCVA improved from 0.60 ± 0.29 LogMAR 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 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 at 6 months. No significant changes in IOP were noted. Discussion: LB-VD allowed clear visualization of the vitreous body and posterior hyaloid, facilitating key vitreoretinal surgical tasks. It provides an effective and safe alternative to traditional dyes currently used in vitreoretinal surgery.