title: Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract.
abstract: OBJECTIVE
  To assess the feasibility, risks, and postoperative outcomes of phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorhexis (CCC) in the absence of a red reflex.
  
  
  METHODS
  Dr. Agarwal's Eye Hospital, Chennai, India.
  
  
  METHODS
  This prospective study comprised 52 eyes of 52 patients with white cataract that had phacoemulsification through a clear corneal temporal incision with PC IOL implantation. In all the cases, trypan blue was used under air to stain the anterior lens capsule and the karate-chop technique was used to emulsify the nucleus. The mean follow-up was 192.2 days.
  
  
  RESULTS
  Trypan blue adequately stained the anterior lens capsule in all cases. The CCC was completed uneventfully in 96.15% eyes; 3.85% of cases had to be converted to a conventional extraction technique because of the loss of the CCC. The mean phacoemulsification time was 2.2 minutes. Intraocular complications included incomplete capsulorhexis (3.85%) and pupillary miosis (3.80%). Postoperatively, 3 eyes (5.77%) had corneal edema (striate keratopathy) and 1 eye (1.9%) had fibrin in the anterior chamber. Five eyes (9.61%) had more than 2+ cells and flare at 2 weeks. All responded well to intensive topical and subconjunctival steroids. There were no cases of endophthalmitis. The mean central endothelial cell loss, measured in 37 eyes, was 8.5%. Of the 4 eyes (7.69%) that had increased intraocular pressure (IOP) postoperatively, all responded well to medications and the IOP was normal by the second postoperative week. Fifty eyes (96.16%) had a final best corrected visual acuity of 20/30 or better. In 2 cases, the final visual acuity was worse than 20/200 because of preexisting posterior segment pathology.
  
  
  CONCLUSIONS
  Phacoemulsification using trypan blue was safe and effective in managing white cataract and had a high success rate.
authors.affiliation: Dr. Agarwal's Eye Hospital, Chennai, India.
authors.forename: Soosan
authors.initials: S
authors.lastname: Jacob
authors.forename: Amar
authors.initials: A
authors.lastname: Agarwal
authors.forename: Athiya
authors.initials: A
authors.lastname: Agarwal
authors.forename: Sunita
authors.initials: S
authors.lastname: Agarwal
authors.forename: Saurabh
authors.initials: S
authors.lastname: Chowdhary
authors.forename: Reena
authors.initials: R
authors.lastname: Chowdhary
authors.forename: Anand A
authors.initials: AA
authors.lastname: Bagmar
mesh_terms: D000368:Aged; D019923:Capsulorhexis / Q000379:methods*; D002386:Cataract / Q000150:complications*; D004396:Coloring Agents; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000033:anatomy & histology*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D012449:Safety; D013194:Staining and Labeling / Q000379:methods; D014343:Trypan Blue; D014792:Visual Acuity
chemical_list: D004396:Coloring Agents; D014343:Trypan Blue