Trypan blue inappropriately impregnated in posterior capsule during phacoemulsification

Poster Details

First Author: C.Garcia BRAZIL

Co Author(s):    L. Molina   M. Manica           

Abstract Details

Purpose:

Report an intraoperative complication related to the use of 0,1% Trypan blue during phacoemulsification.

Setting:

CEPOA - Centro de Estudos e Pesquisas Oculistas Associados, Rio de Janeiro - RJ, Brazil

Methods:

OT, 73-year-old, diabetic and hypertensive, went to the hospital complaining of decreased vision in both eyes (BE), with progressive worsening in the right eye (RE) and no history of trauma. On examination, corrected visual acuity of 20/200 RE, without facodonese or other signs of zonular change, and visual acuity in the left eye (LE) of 20/70. At Biomicroscopy, nuclear cataract showed 3 + / 4 + nuclear cataract in RE and 2 + / 4 + in LE. Was performed phacoemulsification with intraocular lens implantation RE. We used 0.1% trypan blue dye to get a better view of the anterior lens capsule and control of continuous circular capsulotomy. After hydrodissection and rotation of the nucleus, we observed a complete loss of red reflex, which occurred due to migration of trypan blue through the zonules, reaching the canal of Petit and hyaloid membrane above and, consequently, the posterior aspect of the posterior capsule.

Results:

The excess trypan blue injected combined with rising pressure by anterior chamber air bubble were the determinants of extravasation of the dye.

Conclusions:

The difficulty here was to perform phacoemulsification without red reflex. We evaluate the possibility of dislocate the lens into the anterior chamber, converting the surgery to extracapsular. FINANCIAL DISCLOSURE?: No