[Role of trypan blue in epiretinal membrane surgery]. / Intérêt du bleu trypan dans la chirurgie des membranes épirétiniennes.

INTRODUCTION: Idiopathic epiretinal membrane (ERM) results from detachment of the posterior hyaloid. Vitrectomy and peeling are the treatment of choice. Trypan blue 0.15% (TB) stains the epiretinal membrane and the internal limiting membrane (ILM), facilitating surgery and thus allowing selective and complete removal with less retinal damage. We conducted a study evaluating the advantages of selective staining associated with surgery, the incidence of postoperative damage, and the influence on final visual acuity. MATERIAL AND METHODS: Fourteen patients were operated on by the same surgeon, who carried out a complete vitrectomy, then fluid-air exchange for dye injection of undiluted 0.2 ml of Trypan blue 0.15% in front of the membrane, which was then easily distinguished from the area under the retina. Preoperative visual acuity, postoperative damage, as well as eye status at the end of follow-up are discussed. Transmission electron microscopy was used to determine if epiretinal membrane removal was complete and selective. Angiography was systematically used to study the state of retina before and after surgery. RESULTS: Preliminary results show that trypan blue is useful and facilitates complete removal of ERM and ILM. It may reduce long-term complications and recurrent membrane formation. Trypan blue is a staining agent that is quick and easy to use. It presents no short-term toxic effects. Functional results in 6 months show improvement of visual acuity and disappearance of metamorphopsia. CONCLUSION: Idiopathic epiretinal membrane surgery with tryptan blue staining is a better alternative than indocyanine green staining.

[Lymphoma revealed by isolated obliquus inferior muscle involvement in exophthalmia]. / Lymphome révélé par une atteinte isolée du muscle oblique inférieur.

Orbital lymphomas account for 4% of nontraumatic orbital disorders. We report the case of a 54-year-old patient who presented with binocular diplopia associated with right exophthalmia with an isolated obliquus inferior localization. This lymphomatous localization was unexpected, as lymphomas are described more often in the rectus superior and inferior muscles. Pathological examination found a low-grade non-Hodgkin's MALT lymphoma. This case is the basis of a review of the various diagnoses and the necessity of a biopsy prior to surgical tumor ablation that may damage an oculomotor muscle. Treatment should be medical: first-intention surgery would have abolished obliquus inferior function.