Trypan blue as a surgical adjunct in pediatric cataract surgery

Purpose: To study the effect of trypan blue on lens capsule elasticity and ease of completing a continuous curvilinear capsulorhexis (CCC) in a sheep lens model and to subsequently observe the effects of trypan blue in the surgical setting of 3 pediatric patients.

Setting: State University of New York, Downstate Medical Center, Brooklyn, New York, USA.

Design: Prospective case series.

Methods: Twenty-four lenses were excised from fresh sheep globes. Twelve lenses were immersed in trypan blue for 2.5 minutes, and 12 lenses were immersed in a balanced salt solution for 2.5 minutes. Ease of completion of CCC was graded, and intralenticular pressure was quantified. A pediatric cataract surgeon used trypan blue to stain the lens capsules of 3 children during cataract surgery. The surgeon noted the effects of trypan blue on capsule elasticity and on the ease of completion of the CCC.

Results: Lenses immersed in trypan blue had a mean score of 2.58 in ease of completion of capsulorhexis compared with the control group (1.5) (P = .031). Capsulorhexis was successfully completed in 91.7% of trypan blue cases compared with 58.3% of controls. Immersion in trypan blue decreased the intralenticular pressure by a mean of 4.5 mm Hg (P = .025). Successful capsulorhexis was completed in the 3 pediatric cases.

Conclusion: Trypan blue improved the success rate of CCC completion in the sheep lens by decreasing lens capsule elasticity.

Financial disclosure: None of the authors has a financial or proprietary interest in any material or method mentioned.