Inadvertent staining of the posterior lens capsule with trypan blue dye during phacoemulsification.
Inadvertent staining of the posterior lens capsule with trypan blue dye during phacoemulsification.
复制标题
在超声乳化手术期间无意中用台盼蓝染料染色晶状体后囊。
DOI：
10.1001/archopht.119.7.1082
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
George S. Turner
中科院分区：
文献类型：
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作者：
Wayne Birchall;Matthew K. Raynor;George S. Turner
国家从后囊膜表面，给浅蓝色的外观。可见一小块残留的中央后囊纤维化，这也可能是造成不透明外观的原因。可见人工晶状体周围的黑色囊状光晕。眼底摄影未记录眼底细节。16小时后，可见非常微弱的红色反射（图2），1周后，后囊膜的蓝色变色消失，椎间盘和视网膜不再呈现蓝色。由于视网膜脱离后黄斑瘢痕形成，视力维持在3/60左右。在成熟的白色白内障超声乳化术中，提倡使用重要的染料台锥蓝染色前晶状体囊，促进囊裂1，而且它似乎没有不良反应，包括角膜内皮毒性作用。最近对尸体眼睛的研究证实，这种染料也会染色后囊。然而，锥虫蓝分子很大，在正常情况下不会穿过完整的纤毛带（晶状体小带）；一个完整的前玻璃体表面可能会阻止染料大量流入玻璃体腔。据推测，在我们的患者中，未观察到的晶状体带状裂开，可能是由于之前的平面部玻璃体切除术引起的前晶状体表面与后晶状体表面的某种程度的分离，使得染料进入并染色后囊。另一个潜在的屏障，环状透明膜囊韧带（Weiger），在我们患者的年龄已不再完整。可见后囊膜染色足够深，阻止了充足的光线进出视网膜，从而消除了红色反射，残留的囊纤维化可能导致了囊在同轴光照下的不透明外观。虽然本病例没有明显的不良反应，但当在复杂的玻璃体切除术后白内障手术中使用台泮蓝时，应该警惕这种暂时现象的可能性。
nation from the surface of the posterior capsule, giving the pale blue appearance. There was a small area of residual central posterior capsule fibrosis, which may also have contributed to the opaque appearance. Note the halo of dark capsule around the intraocular lens implant. No fundal details were recordable by fundus photography. Sixteen hours later, a very faint red reflex was discernible (Figure 2), and at 1 week the blue discoloration of the posterior capsule had cleared and the disc and retina no longer appeared blue. Visual acuity remained poor at 3/60 because of macular scarring after the retinal detachment. Use of the vital dye trypan blue to stain the anterior lens capsule and facilitate capsulorrhexis for phacoemulsification of mature white cataract has been advocated, 1 and it appears to be free of adverse effects, including corneal endothelial toxic effects. 2,3 Recent studies on cadaver eyes confirm that the dye will also stain the posterior capsule. 4 The trypan blue molecule is large, however, and under normal circumstances does not appear to cross the intact zonula ciliaris (lens zonules) 5 ; it is likely that an intact anterior hyaloid face would prevent bulk flow of dye into the vitreous cavity. Presumably, in our patient, unobserved zonular dehiscence and possibly some degree of separation of the anterior hyaloid face from the posterior lens surface caused by previous pars plana vitrectomy allowed the dye to gain access to and stain the posterior capsule. Another potential barrier, the annular hyaloideocapsular ligament (of Weiger), is no longer intact at our patient’s age. It appears that the posterior capsule was sufficiently deeply stained to prevent adequate light transmission to and from the retina, thus abolishing the red reflex, and the residual capsular fibrosis probably contributed to the opaque appearance of the capsule on coaxial illumination. Although there were no apparent adverse effects in this case, one should be alert to the possibility of this temporary phenomonen occurring when trypan blue is used during complex postvitrectomy cataract surgery.