Abstract
Purpose: :
To present 2 cases of posterior capsule staining with tryptan blue during cataract surgery on patients with patent peripheral iridotomies
Methods: :
A series of patients undergoing cataract surgery using tryptan blue who unexpectedly developed posterior capsular staining
Results: :
Both patients experienced 'blue tinged' vision for a week following their surgery before recovering fully, acheiving 20/20 vision
Conclusions: :
Phacoemulsification cataract surgery is the standard treatment for cataract in the developed world. A critical step in this form of surgery is the ability to create a continuous curvilinear capsulorrhexis. In cases where visualisation of the anterior capsule is compromised, intracameral dyes such tryptan blue can be used. This is a bis-azo dye which stains poorly hydrated tissues such as the basement membrane of the lens capsule Rarely the posterior capsule becomes stained, reducing the red reflex, paradoxically increasing the difficulty of the cataract surgery.The posterior capsule staining in these cases probably resulted from a defect in the superior zonules produced by the YAG laser, thereby allowing the tryptan blue access to the space between the anterior hyaloid face and the posterior lens capsule (Berger’s space).Surgeons, in particular trainee surgeons, should be aware that there is a risk of posterior capsule staining when using trypan blue in eyes with a patent peripheral iridotomy.
Keywords: cataract • laser