Dye-enhanced cataract surgery - Part 1: Anterior capsule staining for capsulorhexis in advanced/white cataract

Purpose: To evaluate anterior capsule staining using 3 dyes to perform cont inuous curvilinear capsulorhexis (CCC) in postmortem human eyes with advanc ed/white cataract. Setting: Center for Research on Ocular Therapeutics and Biodevices, Storm E ye Institute, Medical University of South Carolina, Charleston, South Carol ina, USA. Methods: In experimental closed-system surgery, CCC was performed in 12 pos tmortem human eyes with cataract after the anterior capsule was stained wit h 3 capsule dyes (fluorescein sodium 2%, indocyanine green [ICG] 0.5%, and trypan blue 0.1%). Two commonly used techniques for capsule staining were a lso compared: staining within an air bubble and intracameral subcapsular in jection of dye. Results: In all globes, CCC was uneventful using the 3 dyes and with both t echniques. With the intracameral subcapsular injection, the dye remained tr apped in the subcapsular space in contact with the posterior surface of the anterior capsule, allowing enough time to perform any maneuver. The staini ng provided by ICG, at the concentration used, was slightly superior to tha t of the other dyes. Leakage of fluorescein sodium into the vitreous cavity was seen using the Miyak-Apple posterior video/ photographic technique. Conclusion: Intracameral subcapsular injection of ICG allowed the easiest r ecognition of the capsular flap by staining the posterior surface of the an terior capsule and without leaking into the vitreous cavity. J Cataract Ref ract Surg 2000; 26. 1052-1059 (C) 2000 ASCRS and ESCRS.