Effect of trypan blue staining on the elastic modulus of anterior lens capsules of diabetic and nondiabetic patients

Abstract

Trypan blue contributed to increased capsule stiffness during capsulorhexis, especially in diabetic patients.

Comparison of capsulorhexis resistance to tearing with and without trypan blue dye using a mechanized tensile strength model

“…[11][12][13] This finding can most likely be explained by the nature of our model. We do not believe we can accurately calculate elasticity in terms of the extensibility of the capsulorhexis by using our extension data to calculate the stretched circumference.…”

“…The elasticity measurements were obtained using a modified rheometer and compared with measurements in controls. 12 A study by Jardeleza et al 13 used nanoindentation to support the finding of increased stiffness and also described a more significant effect in diabetic patients. In a porcine model, Wollensak et al 11 found that the application of trypan blue to the anterior capsule followed by at least 1 minute of light irradiation increased elastic stiffness at 25% strain and reduced the ultimate extensibility.…”

“…19 Another use of trypan is to examine corneoscleral buttons before corneal transplantation, 25 and concentrations of up to 0.40% were found to have no cytotoxic effect on rabbit corneal endothelial cells in culture. 6 Because of previous studies describing decreased anterior capsule elasticity after trypan blue staining, [11][12][13] we decided to use our cadaver eye model to verify the influence of decreased elasticity on the CCC resistance to tearing. 20 In this study, the mean load and extension at capsulorhexis tearing in isolated entire capsular bags did not differ significantly between trypan blue-stained cadaver eyes and control cadaver eyes.…”

“…[5][6][7][8][9][10] Trypan blue has been reported to cause changes in the lens capsule that may result in decreased elasticity and increased stiffness. [11][12][13] One study 11 found that it may have a role as a photosensitizer, resulting in crosslinking of capsule collagen. The effect of trypan blue on lens epithelial cells (LECs) has been studied for possible use in prevention of capsular bag opacification.…”

Trypan blue dye for anterior segment surgeries

“…54 The impairment of elastic properties of the lens capsule could increase the risk for capsular tears and may result in a higher incidence of intraoperative complications. A reduction in the elasticity of the anterior capsule has been reported in studies using human anterior capsule, 54 with a suggestion that this is more significant in diabetic, compared with non-diabetic patients, 55 in a process that appears to be light-exposure dependent. 56 TB has also been reported to stain hydrophilic acrylic IOLs in digital image analysis, but not poly methylmethacrylate or silicone lenses 12 after prolonged exposure of 180 min in in vitro testing.…”