Cataract surgery vision blue enhancing anterior capsule visualization during the cataract phacoemulsification over the past few years
Cataract Surgery Vision Blue
Internationally, trypan blue has been used in addition to enhancing anterior capsule visualization during cataract phacoemulsification over the past few years. Over time, ingenuity and observation by doctors and surgeons has resulted in other uses for dye, and many specific applications have been demonstrated. Anterior anterior dyeing is a helpful and simple procedure when poor red reflexes become a concern during phacoemulsification. Trypan blue is an effective dye that is useful in many other examples beyond the regular anterior capsule dye during cataract surgery. Conditions that cause undisturbed red reflexes contribute to poor visualization of the anterior capsule during cataract surgery, making capsulorrhexis much more difficult. A poor anterior capsulorrhexis can lead to an increased complication rate. Therefore, capsular dyeing is considered helpful in eyes that contain mature cataracts and eyes with poor red reflexes due to conditions such as corneal scarring and edema, asteroid hyalosis, vitreous hemorrhage, and retinal disease.
In corneal surgery, trypan blue may be used to color the posterior stromal fibers during the inner endothelial keratoplasty (DLEK) and to color the endothelium in the endotelial endemias desiccat keratoplasty (DSEK) before removing the Descemet membrane. Trypan blue has also proven to be a useful addition in vitreoretinal surgery and in the case of proliferative vitreoretinopathy. Dye enhancement has been used to facilitate the identification, delineation, and removal of epiretinal membranes, internal limiting membranes, and posterior hyaloid during vitrectomy cases. In oculoplastics surgery, extraocular indications have been described to stain the capsule of Tenon during enucleation surgery.
There are two techniques cataract surgery vision blue
Different techniques for applying this stain have been described without significant differences in surgical outcomes. There are two widely used techniques for cataract capsular staining, the first being a trypan blue injection into the anterior chamber below the air bubbles and the second is injection under viscoelastic. In both techniques, a drop of a capsular dye is placed in space after introducing either filtered air or viscoelastic material. Both scenarios involve the painting of the capsule prior to the initiation of the continuous curve capsulorrhexis. There were no statistically significant differences in phacoemulsification time, total surgery time, best post-operative correction vision, central corneal thickness, or endothelial cell counts between the two groups. The authors conclude that both methods are equally effective and safe.
Surgeons have long used dyes such as green indocyanine, fluorescein, and trypan blue to color anterior capsules to facilitate surgical procedures. However, a study comparing these three dyes concluded that trypan blue provides much more intensive staining on anterior lens capsules than others. Trypan blue is easier to use than green indocyanine, the reason Trypan blue comes in a diprexed solution, and is available at a more economical price. The ophthalmologist should also be careful when inserting a hydrophilic intraocular lens (IOLs) in the patient. IOL can absorb the trypan blue and become discolored if the dye is used for long periods of time. The side-effects of IOL color changes such as minor staining of the posterior and vitreous capsules are generally limited and of short duration, usually disappear within a week, the FDA does not recommend using dye completely in conjunction with hydrophilic IOL implantation. Teratogenic effects have also been noted in early animal studies when trypan blue was injected intravenously at high doses.
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