Adjunct devices for managing challenging cases in cataract surgery: capsular staining and ophthalmic viscosurgical devices.
OBJECTIVE
Cataract surgeons should employ all reasonable technology to facilitate safe and consistent outcomes. Knowledge of adjunct devices to enhance visualization of the capsular bag and appropriate use of ophthalmic viscosurgical devices allow for enhanced protection of intraocular structures and reduced rates of complication.


RESULTS
Trypan blue is US Food and Drug Administration-approved for facilitating visualization of the anterior capsule. Animal data demonstrate Brilliant Blue G to be an effective capsular stain with a superior safety profile. Healon5 is a safe viscosurgical device that is particularly useful in children, poorly dilating pupils, intraoperative floppy-iris syndrome, and intumescent cataracts. The viscoadaptivity of Healon5 enables its utility throughout the procedure of cataract extraction. The recent literature on capsular dyes and advances in ophthalmic viscosurgical technology is reviewed.


CONCLUSIONS
Inadequate capsular visualization and poor tissue stabilization/protection increase the chance of discontinuous capsulorhexis, retained nuclear material, vitreous loss and corneal decompensation. Utilization of adjunctive tools in the setting of challenging cataract cases can significantly limit adverse intraoperative outcomes and result in reproducible surgical success.
Goldman
James M
JM
Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
Karp
Carol L
CL
D000818:Animals; D002387:Cataract Extraction / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D006820:Hyaluronic Acid; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D013194:Staining and Labeling / Q000379:methods*; D013536:Suture Techniques / Q000295:instrumentation*; D014783:Viscosity
D006820:Hyaluronic Acid