Dye-enhanced cataract surgery - Part 3: Posterior capsule staining to learn posterior continuous curvilinear capsulorhexis

Purpose: To evaluate the use of 2 dyes for staining the posterior capsule t o enhance visualization during posterior continuous curvilinear capsulorhex is (PCCC). 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 sta in the posterior capsule for performing PCCC in 8 human eyes obtained postm ortem. The eyes were prepared according to the posterior video technique of Miyake-Apple. After CCC and hydrodissection/delineation were performed, th e nucleus was carefully delivered by hydroexpression. Cortical cleanup was completed by irrigation/aspiration. The posterior capsule was stained by in stilling 1 microdrop of ICG (4 eyes) or trypan blue (4 eyes) in the capsula r bag. A PCCC was then performed by 2 independent surgeons (4 eyes/surgeon) not familiar with this technique. Each surgeon also performed PCCC in 2 ey es without the use of dye. Results: Both eyes facilitated the performance of PCCC after staining the o therwise transparent posterior capsule. it was easier to differentiate the stained posterior capsule flap from the underlying transparent anterior hya loid phase of the vitreous. In addition, optic capture of an intraocular le ns, with or without anterior vitrectomy, was easily accomplished because of the enhanced visualization by posterior capsule staining. Conclusion: Posterior capsule staining can be successfully used to learn an d perform the PCCC procedure, combined with optic capture, anterior vitrect omy, or both. J Cataract Refract Surg 2000, 26: 1066-1071 (C) 2000 ASCRS an d ESCRS.