PURPOSE: The aim of the study is to explore the effectiveness of using monochrome mode with Brilliant Blue G during vitrectomy surgery with the NGENUITY 3D Visualization System. METHODS: Vitrectomy cases involving BBG-stained internal limiting membrane peeling with the NGENUITY 3D Visualization System (Alcon Laboratories, Inc.) at Juntendo University Urayasu Hospital from October 2022 to February 2023 were selected. The contrast ratios between peeled and stained internal limiting membrane areas under three settings were assessed: normal, yellow, and monochrome. In the monochrome setting, a yellow hue was used with zero saturation, while the Friedman test compared these ratios. RESULTS: Nineteen patients (19 eyes
7 males, 12 females
average age 68.5 ± 10.3 years) with retinal conditions such as epiretinal membrane (n = 11), macular hole (n = 4), macular traction syndrome (n = 3), and retinoschisis (n = 1) were included. We obtained contrast ratios of 1.57 ± 0.21 (normal), 1.60 ± 0.21 (yellow), and 1.92 ± 0.29 (monochrome). The monochrome setting showed significantly higher contrast than that shown by the normal and yellow settings (P = 0.0001, P = 0.0005), with no difference between the normal and yellow settings (P = 0.903). CONCLUSION: Monochrome mode in NGENUITY with Brilliant Blue G potentially enhances contrast and increases visibility during internal limiting membrane peeling.