Related Experiment Video
Updated: Aug 8, 2026
Ex Vivo and In Vivo Animal Models for Mechanical and Chemical Injuries of Corneal Epithelium
Published on: April 6, 2022
Severe toxic effect of methylene blue 1% on iris epithelium and corneal endothelium
Dimitrios Brouzas1, Dimitrios Droutsas, Antonios Charakidas
1Department of Ophthalmology, University of Athens, Athens, Greece. brouzas@yahoo.com
Purpose:
To report a case of corneal endothelial decompensation and iris pigment dispersion following the inadvertent use of methylene blue 1% for capsular staining during cataract surgery.
Design:
Case report.
Methods:
During an otherwise routine phacoemulsification cataract surgery, inadvertent anterior capsule staining with methylene blue 1% instead of trypan blue 0.025% was performed. Copious irrigation of the anterior chamber with balanced salt solution was initiated upon identification of the wrong dye. The operation was completed with minimal ultrasound energy without complications.
Results:
Iris discoloration and severe corneal edema developed in the early postoperative period, resulting in severe visual loss. The patient developed bullous keratopathy and underwent penetrating keratoplasty 16 months later.
Conclusions:
In vivo intracameral injection of methylene blue 1% induces extreme cytotoxicity, primarily on the corneal endothelium and iris epithelium.
