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Inadvertent trypan blue posterior capsule staining during cataract surgery
Bryn M Burkholder1, Divya Srikumaran, Afshan Nanji
1The Wilmer Eye Institute/The Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224, USA.
American Journal of Ophthalmology
|December 11, 2012
Summary
Inadvertent posterior capsule staining with trypan blue can occur even in structurally normal eyes during phacoemulsification. Iris retractors may increase this risk by facilitating trypan blue flow to the posterior capsule.
Area of Science:
- Ophthalmology
- Surgical Complications
Background:
- Trypan blue is used to stain the anterior capsule during cataract surgery.
- Posterior capsule staining is an uncommon complication.
Purpose of the Study:
- To report five cases of inadvertent posterior capsule staining with trypan blue during phacoemulsification.
- To investigate the mechanisms and risk factors for this complication.
Main Methods:
- Retrospective, observational case series.
- Review of surgical videos from five cases of posterior capsule staining.
- Analysis of intraoperative factors, including the use of iris retractors.
Main Results:
- All five cases involved the use of iris retractors.
- No preoperative evidence of zonular pathology was noted.
- Posterior capsule staining resolved by postoperative day 8 in all cases.
Conclusions:
- Iris retractors may contribute to posterior capsule staining by enabling trypan blue to flow to the posterior capsule.
- Surgeons should consider techniques to minimize this risk, especially when using iris retractors.
