Trypan blue injection into the capsular bag during phacoemulsification: Initial postoperative posterior capsule opacification results

Abstract

To study the effect of injecting trypan blue 0.1% into the capsular bag on posterior capsule opacification (PCO) in eyes having phacoemulsification with foldable intraocular lens (IOL) implantation. Department of Ophthalmology, SMS Medical College & Hospital, Jaipur, India. Comparative case series. Eyes having phacoemulsification were randomized to have 0.2 mL of trypan blue 0.1% injected subcapsularly at 2 sites 180 degrees apart after cortical-cleaving hydrodissection (trypan blue group) or 0.2 mL of a balanced salt solution injected in a similar fashion (control group). Six- and 12-month postoperative PCO was analyzed by a masked examiner using public-domain open-source software (ImageJ) on digital retroillumination images. The PCO score Σ[% area × PCO grade (0 to 4)] was compared between the groups using the paired t test. The trypan blue group comprised 150 eyes and the control group, 150 eyes. The mean patient age was 62.79 years ± 8.89 (SD) and 63.69 ± 9.20 years, respectively. After applying exclusion criteria, the mean PCO scores at 6 months and 12 months were 0.10 and 0.15, respectively, in the trypan blue group (102 eyes) and 0.21 and 0.25, respectively, in the control group (103 eyes). The difference was statistically significant at 6 months (P=.042) and 12 months (P=.0227). Two eyes in the trypan blue group and 6 eyes in the control group required laser capsulotomy. Intraoperative injection of trypan blue 0.1% into the capsular bag reduced PCO after phacoemulsification with foldable hydrophilic acrylic IOL implantation.