Two cases of toxic anterior segment syndrome from generic trypan blue.
We report 2 cases of toxic anterior segment syndrome (TASS) resulting from impurities in generic trypan blue that was administered intracamerally to improve visualization of the capsule. Histology of the corneal buttons revealed foci of inflammatory response and complete loss of endothelial cells. Cell culture analysis showed that the generic trypan blue was approximately twice as toxic to the endothelium as a proprietary trypan blue. Ophthalmologists should be aware that any substance administered intraocularly can be a source of complications, and they should know the source of all material used in surgery.
University of Nevada, Las Vegas, Nevada, USA. kurtab@cox.net
Kurt
K
Buzard
Jue-Rong
JR
Zhang
Gabriella
G
Thumann
Renata
R
Stripecke
Murad
M
Sunalp
D001013:Aorta, Thoracic / Q000166:cytology; D002470:Cell Survival; D002478:Cells, Cultured; D004396:Coloring Agents / Q000009:adverse effects* / Q000633:toxicity; D015715:Corneal Edema / Q000139:chemically induced* / Q000175:diagnosis; D016568:Drugs, Generic; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000473:pathology; D004731:Endotoxins / Q000009:adverse effects* / Q000633:toxicity; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D014343:Trypan Blue / Q000009:adverse effects* / Q000633:toxicity; D014606:Uveitis, Anterior / Q000139:chemically induced* / Q000175:diagnosis
D004396:Coloring Agents; D016568:Drugs, Generic; D004731:Endotoxins; D014343:Trypan Blue