Use of Brilliant Blue G in Descemet’s Membrane Endothelial Keratoplasty

Vital staining of the endothelial graft is essential during Descemet’s membrane endothelial keratoplasty (DMEK) to ensure surgical success. DMEK surgeons worldwide commonly use trypan blue (TB) to this end. However, TB may exert toxic effects on both the cornea and retina. Recently, Brilliant Blue G (BBG) has become recognized as an alternative stain for use during vitreoretinal surgery; BBG is associated with lower levels of toxicity. We retrospectively analyzed the utility of BBG staining during DMEK. We used 0.1% (w/v) BBG to stain the DMEK grafts of 12 patients. We evaluated the best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), and endothelial cell density (ECD) before and 3 and 6 months after surgery. BBG was effective in terms of graft visualization during DMEK. The BSCVA () improved from to (). The CCT decreased from  μm preoperatively to  μm at 6 months postoperatively (). The ECD decreased from  cells/mm2 to  cells/mm2 at 6 months postoperatively (). The ECD loss was . The outcomes using BBG were comparable to those of earlier reports that employed TB; thus, BBG may be a viable alternative to TB.

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