Determining the lowest trypan blue concentration that satisfactorily stains the anterior capsule.
OBJECTIVE
To determine the lowest concentration of trypan blue that will stain the anterior capsule satisfactorily to perform a safe continuous curvilinear capsulorhexis and to describe a staining technique using a dispersive viscoelastic material.


METHODS
Cerrahpasa School of Medicine, University of Istanbul, Istanbul, Turkey.


METHODS
Trypan blue 0.1% (Vision Blue) was diluted by half by adding an equal volume of balanced salt solution (BSS) in a stepwise pattern continuously until the concentration failed to stain the anterior capsule satisfactorily. After the dilution, 4 concentrations of the dye were obtained: 0.050%, 0.025%, 0.0125%, and 0.00625%. The volume of dye used for staining was 0.1 cc at all concentrations. Each concentration of the dye was applied using a classic air-bubble technique or a technique in which the dye was injected under sodium hyaluronate 3.0%-chondroitin sulfate 4.0% (Viscoat) onto the anterior lens surface without using an air bubble to reform the anterior chamber. Each diluted concentration was used in 10 eyes by the same surgeon, with 5 eyes having the air-bubble technique and 5 having the viscoelastic technique. The 0.1% concentration was used in 5 eyes, all having the viscoelastic technique.


RESULTS
Trypan blue in concentrations as low as 0.0125% stained the anterior capsule satisfactorily. In addition, staining was possible under the Viscoat. The viscoelastic technique was faster, safer, and easier to perform than the air-bubble technique.


CONCLUSIONS
As trypan blue is a potentially carcinogenic vital dye and its possible long-term side effects are unknown, the lowest effective concentration should be used. A concentration lower than 0.1% was effective in staining the anterior capsule even under dispersive viscoelastic material.
Yetik
Huseyin
H
University of Istanbul, Cerrahpasa School of Medicine,Department of Ophthalmology, Istanbul, Turkey. hyetik@hotmail.com
Devranoglu
Kazim
K
Ozkan
Sehirbay
S
D019923:Capsulorhexis; D004396:Coloring Agents / Q000008:administration & dosage*; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery*; D018918:Phacoemulsification; D013194:Staining and Labeling / Q000379:methods*; D014343:Trypan Blue / Q000008:administration & dosage*
D004396:Coloring Agents; D014343:Trypan Blue