Comparison of dyes for cataract surgery. Part 2: efficacy of capsule staining in a rabbit model

To investigate the efficacy of various dyes for anterior capsule staining to facilitate capsulorhexis during cataract surgery.

Department of Ophthalmology and Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Various concentrations of indocyanine green (ICG), methylene blue (MB), gentian violet (GV), trypan blue (TB), and fluorescein sodium (FS) were used to stain rabbit lenses in vitro. After 1 minute of exposure, the staining of each lens was evaluated using a semiquantitative scoring system in which 0 represented no staining/no contrast between the capsule and cortex and 4 represented excellent staining/remarkable contrast between the stained capsule and unstained cortex. The lowest concentration of dye with a score of 4 was considered the lowest effective concentration for capsulorhexis.

Based on our scoring system, the lowest effective concentrations for capsulorhexis were ICG 0.25%, MB 0.10%, GV 0.01%, TB 0.10%, and FS 1.25%. The lowest effective concentrations of the 5 dyes provided comparable contrast. Increased concentrations of dye decreased contrast between the capsule and the cortex and were considered less effective for capsulorhexis.

Any of the following concentrations of dyes can be used for optimal enhancement of anterior capsule visibility for capsulorhexis: ICG 0.25%, MB 0.10%, GV 0.01%, TB 0.10%, and FS 1.25%.