J Korean Ophthalmol Soc.  2008 Jul;49(7):1189-1193. 10.3341/jkos.2008.49.7.1189.

Inadvertent Staining of the Vitreous with Trypan Blue During Cataract Surgery

• Lee MY
• Lee HS
• Joo CK

• KMID: 1476977
• DOI: http://doi.org/10.3341/jkos.2008.49.7.1189

Abstract

PURPOSE
We report a case of inadvertent staining of the vitreous with Trypan Blue during cataract surgery.
CASE SUMMARY
We performed cataract surgery in a 44-year-old male patient on an eye with mature cataract. Preoperatively, he had no zonular weakness or lens subluxation. We used trypan blue to stain the anterior capsule to facilitate capsulorhexis. We observed zonular weakness during surgery. During phacoemulsification, the dye entered into the vitreous cavity through the area of zonular weakness and a sudden loss of the red fundus reflex developed. However, we did not perform any specific procedure to correct the problem and finished phacoemulsification and intraocular lens insertion. After surgery, slit lamp examination showed a blue fundal glow, which persisted for 1 week. As expected, the patient's BCVA was better than before the operation.
CONCLUSIONS
Use of trypan blue is relatively safe for use in cataract surgery. But to use trypan blue or other dye during cataract surgery, it is necessary to have careful pre operative ocular examination. And if some risk factors like zonular weakness or lens subluxation exists, more caution during surgery is needed.

Keyword

Trypan blue; Zonulysis

MeSH Terms

Adult
Capsulorhexis
Cataract
Diminazene
Eye
Humans
Lens Subluxation
Lenses, Intraocular
Male
Phacoemulsification
Reflex
Risk Factors
Trypan Blue
Diminazene
Trypan Blue

Figure

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  Figure 1. Zonulysis and prolapsed vitreous were found during cataract surgery, and tension ring was applied.

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  Figure 2. Fundus photograph on the first postoperative day shows a moderate bluish hue in the vitreous cavity.

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  Figure 3. Slitlamp examination on the first postoperative day reveals a slight blue fundal glow instead of an orange glow.

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  Figure 4. Fundus photograph 1 week after opeartion shows normal red fundus reflex.

Reference

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