Trypan-blue- and endoillumination-assisted phacoemulsification in eyes with vitreous hemorrhage during combined cataract and vitreous surgery.
OBJECTIVE
To study the safety and usefulness of trypan blue application and conventional endoillumination for enhancing visualization during phacoemulsification and foldable intraocular lens implantation in cases of cataract with vitreous hemorrhage.


METHODS
Ten eyes of 10 patients with cataract and coexisting vitreous hemorrhage underwent combined trypan-blue- and endoillumination-assisted phacoemulsification and foldable intraocular lens implantation with vitrectomy. In a two-step surgery, after staining the anterior capsule with trypan blue, continuous circular capsulorhexis was performed; then, phacoemulsification was performed using conventional endoillumination. Specular microscopy was performed before and 3 months after surgery on eyes that underwent trypan-blue- and endoillumination-assisted phacoemulsification and on control eyes that underwent standard phacoemulsification to evaluate the toxic effect of trypan blue on corneal endothelial cells.


RESULTS
Trypan blue application improved visualization of the anterior capsule, and a complete capsulorhexis could be performed in all eyes. In all 10 eyes, endoillumination was required to visualize the lens structure, and phacoemulsification could be accomplished. Specular microscopy revealed that there was no significant difference in the level of corneal endothelial cell loss between the trypan-blue- and endoillumination-assisted phacoemulsification group and the control group.


CONCLUSIONS
The described double visualization technique may assist phacoemulsification in selected cases of cataract with vitreous hemorrhage.
Yamamoto
Narumichi
N
Department of Ophthalmology, Tokyo Metropolitan Komagome Hospital, Japan. naruy@cick.jp
Ozaki
Noriko
N
Murakami
Kimio
K
D000368:Aged; D019923:Capsulorhexis / Q000379:methods; D002386:Cataract / Q000150:complications / Q000628:therapy*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000033:anatomy & histology; D019654:Lens Implantation, Intraocular; D008029:Lighting; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D014343:Trypan Blue; D014821:Vitrectomy / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000150:complications / Q000601:surgery*
D004396:Coloring Agents; D014343:Trypan Blue