Intraoperative efficacy and clinical outcomes of two commercial staining solutions used in idiopathic epiretinal membrane surgery

Purpose To compare two commercially available staining solutions (MembraneBlue Dual (R) by D.O.R.C., Netherlands, and TWIN by AL.CHI.MI.A. S.R.L., Italy), in terms of intraoperative handling, staining efficacy and safety, in eyes undergoing surgery for idiopathic epiretinal membrane (ERM). Methods In this observational cross-sectional study, the performance of the dyes used during the procedure (cohesion, ERM and internal limiting membrane [ILM] staining efficacy) was scored by the surgeon using a customized questionnaire after 10 procedures with each of the two dyes. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), blue-light fundus autofluorescence (BAF), and microperimetry-determined retinal sensitivity were reviewed preoperatively and then at 1 and 3 months after surgery. Results ILM staining efficacy with TWIN was scored 2.89 +/- 0.33 by the surgeons, which turned out to be higher than with MembraneBlue Dual (R) (1.90 +/- 0.31, P = 0.0002). The cohesion score was 2.70 +/- 0.48 for TWIN and resulted significantly higher than with MembraneBlue Dual (R) (1.60 +/- 0.51, P = 0.0010). BCVA, CFT and retinal sensitivity were similar in the two groups, 1 and 3 months postoperatively (P nonsignificant for all). Conclusions Both TWIN and MembraneBlue Dual (R) dyes showed suitable staining properties and equivalent safety and efficacy profiles, both intra- and postoperatively. The TWIN dye might offer a solution for surgeons who prefer a more cohesive and stable dye.