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Young Min Park, Jong Moon Park, Sung Who Park, Jong Soo Lee; Is Trypan blue capsular staining really safe in cataract surgery?. Invest. Ophthalmol. Vis. Sci. 2018;59(9):432.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the safety of 0.03% trypan blue for staining the anterior capsule in cataract surgery.
The patients were classified into two groups. The trypan blue group comprised patients who had capsule staining with 0.03% trypan blue. The control group comprised patients who had capsulorhexis performed with an intracameral illuminator. The medical records of patients with vitreous hemorrhage who had pars plana vitrectomy and cataract surgery were reviewed. Preoperative and postoperative assessment included best corrected visual acuity, slit lamp examination, intraocular pressure, corneal endothelial status evaluated with specular microscopy at baseline, and at one and three months after surgery. The status of the endothelial cells in both groups was analyzed. Safety of 0.03% trypan blue on corneal endothelium was evaluated.
Forty-five eyes were assigned to the trypan blue group and 41 eyes to the control group. Compared with the control group not showing significant endothelial cell density (ECD) changes postoperatively, the trypan blue group showed significant postoperative ECD loss at one month (7.91% loss, P < 0.001) and at three months (9.65% loss, P < 0.001). ECD did not decrease in 43.9% (18 eyes) of the control group, which was significantly greater than the 17.1% (7 eyes) of the trypan blue group. (P=0.004).
The ECD of the eyes decreased more with 0.03% trypan blue staining than those of the control group. Safety of trypan blue staining is not secured enough to abuse in all sort of cataract. Trypan blue should be used with caution, especially in patients with low preoperative ECD.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1. A continuous curvilinear capsulorhexis performed using 0.03% trypan blue (A) and intracameral illuminator (B).
Figure 2. Loss of the endothelial cell density at 3 months after surgery.
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