Abstract
Purpose: :
To compare the effectiveness, cellular toxicity, and cost implications of disposable sterile surgical marker pen ink (Gentian violet) and commercial Trypan blue in staining of anterior lens capsule in cataract surgery.
Methods: :
The ink cartridge of Aspen Sterile Surgical Marking Pen was first removed and the ink was extracted by irrigating balanced salt solution (BSS) through the cartridge. The resulting ink solution was then aspirated through a 5 micron filter straw to a 3cc syringe to obtain the desired ink solution. This can be prepared readily in the operating room. This ink solution was then used to compare with commercially available Trypan blue capsular staining solution and BSS was used as a control. Cultured corneal epithelial cells were used to evaluate toxicity of the maker ink while commercial available trypan blue was used as control. Human lens capsules (obtained from eye bank eyes) were used to evaluate the effectiveness of capsular staining. Cultured corneal epithelial cells were incubated with pH adjusted marking pen ink, Trypan blue and BSS at fixed durations and toxicity were measured with Phase contrast microscope (Nikon TE200 Inverted Microscope, Nikon USA, Melville, NY). Furthermore, the cost of ink pen and filter straw with commercially available Trypan blue staining solution were compared.
Results: :
pH adjusted disposable marker ink solution showed similar cytotoxicity profile in comparison to Trypan Blue. The effectiveness of capsular staining of the marker ink is also similar to that to Trypan blue. The cost of the marking pen ink is only a fraction of the commercially available Trypan blue preparation.
Conclusions: :
Surgical marking pen ink can be easily prepared in the OR and may be used as a safe and inexpensive alternative to Trypan Blue in visualization of anterior lens capsule during cataract extraction. This approach may be particularly useful in developing countries.
Keywords: cataract • cornea: epithelium • drug toxicity/drug effects