Dye-enhanced cataract surgery - Part 2: Learning critical steps of phacoemulsification

Purpose: To use capsule dyes to enhance visualization to learn and perform various critical steps of the phacoemulsification procedure in a laboratory setting using postmortem human eyes. Setting: Center for Research on Ocular Therapeutics and Biodevices, Storm E ye Institute, Medical University of South Carolina, Charleston, South Carol ina, USA. Methods: Indocyanine green 0.5% (ICG) and trypan blue 0.1% were used to enh ance visualization for performing critical steps of phacoemulsification in 8 human eyes obtained postmortem. All eyes were prepared according to the M iyake-Apple posterior video technique. After a continuous curvilinear capsu lorhexis (CCC) was made, the dyes were used to enhance visualization for hy drodissection, hydrodelineation, and various maneuvers for nuclear emulsifi cation and cortical cleanup. In 8 eyes, all the aforementioned steps were p erformed without using dye (control group). Results: Both dyes helped enhance visualization during the critical steps o f phacoemulsification. The use of a dye solution instead of balanced salt s olution (BSS(R)) for hydrodissection/delineation helped localize the comple te plane of cleavage between the capsule and cortex and the nucleus-epinucl eus complex. During various nuclear sculpting maneuvers, the use of dye hel ped visualization of the position of the phaco tip and its relation to the posterior capsule. it also helped localize remaining cortical fibers, facil itating complete cleaning of the capsular bag. Conclusion: Dye-enhanced cataract surgery was useful in learning various cr itical steps of phacoemulsification in a wet: laboratory setting. J Catarac t Refract Surg 2000; 26. 1060-1065 (C) 2000 ASCRS and ESCRS.