Trypan blue staining of filtering bleb in eyes with operated trabeculectomy

Dada, Tanuj; Bali, Shveta Jindal; Mohan, Shalini; Bhartiya, Shibal; Sobti, Amit; Panda, Anita

doi:10.3126/nepjoph.v4i2.6536

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…[24] This gives a good idea about the adequacy of subconjunctival filtration in eyes undergoing phacoemulsification and can be used to plan for intraoperative surgical interventions in the form of needling, repeat surgery, or other bleb modulations.…”

Section: Cataract Surgery and Trabeculectomymentioning

confidence: 99%

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Dada

Midha

Shah

et al. 2017

Indian J Ophthalmol

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Trabeculectomy surgery is the current standard of care in glaucoma for achieving a low target intraocular pressure if medical therapy is not adequate. Augmentation of trabeculectomy with antimetabolites brought a revolutionary change in the long-term success rates of trabeculectomy, but along with it came a plethora of complications. There still is a big window for therapeutic innovations on this subject. The foremost target for these innovations is to modulate the wound healing response after glaucoma drainage surgery. Achieving the desired balance between long-term success of filtering blebs versus early failure due to scarring of blebs and hypotony due to dysfunctional filtering blebs poses a unique challenge to the ophthalmologists. Alternatives to trabeculectomy such as glaucoma drainage devices and minimally invasive glaucoma surgeries cannot solve the problem of glaucoma blindness in our country, mainly due to their unpredictable results and unfavorable cost-benefit ratio. In this article, we present a summary of our innovations in glaucoma surgery to advance patient care by making it more effective, safer, and economical.

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Section: Cataract Surgery and Trabeculectomymentioning

confidence: 99%

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Dada

Midha

Shah

et al. 2017

Indian J Ophthalmol

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Indocyanine green–dye staining of a filtering bleb during cataract surgery

Lim

Cheol

2014

Journal of Cataract and Refractive Surgery Online Case Reports

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An 80-year-old woman with primary open-angle glaucoma had had trabeculectomy 2 years earlier.On presentation, slitlamp examination showed an almost mature intumescent cataract. A diffuse, elevated, avascular filtering bleb was observed preoperatively. For visualizing the anterior capsule, 0.3 mL of ICG 0.5% dye was used intraoperatively. During the capsulorhexis, gradual intense staining of the filtering bleb was observed as the ICG dye passed into the bleb. Over the 2 weeks following the uneventful cataract surgery, the ICG dye stain faded away. To our knowledge, this is the first video-documented report of ICG dye staining of a filtering bleb. This case indicates that dye-enhanced phacoemulsification might be helpful in indirectly evaluating the bleb function as well as facilitating the capsulotomy. Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. JCRS Online Case Reports 2014; 2:78-79 Q 2014 ASCRS and ESCRS Online VideoPerforming capsulorhexis as an anterior capsulotomy is an important step in cataract surgery. 1 Thus, various dyes are used to enhance the visibility of the anterior capsule in a white cataract. 1,2 Among them, indocyanine green (ICG) and trypan blue are used widely because of their safety profile. 2 However, no case report has been published on ICG dye staining of a filtering bleb during cataract surgery and its effect. We report a video-documented case of ICG dye staining of a functional filtering bleb and its effect on a patient who had had a trabeculectomy. CASE REPORTAn 80-year-old woman presented at our clinic with decreased vision in her right eye for several months. She had had a trabeculectomy with mitomycin-C in both eyes 2 years earlier to treat primary open-angle glaucoma. The examination showed uncorrected distance visual acuity of hand motion and intraocular pressure (IOP) of 7 mm Hg in the right eye. The slitlamp examination showed an almost totally white lens opacity with intumescence (Figure 1, a). A diffuse, elevated, avascular filtering bleb was observed at the superior conjunctiva in the right eye (Figure 1, b). There was no evidence of phacodonesis, iris atrophy, or previous ocular inflammation.Phacoemulsification was performed via a temporal clear corneal incision under retrobulbar anesthesia. For visualizing the anterior capsule, 0.3 mL of ICG 0.5% dye was injected through a side-port paracentesis. An ophthalmic viscosurgical device, sodium hyaluronate 2.3% (Healon5), was used to stabilize the anterior chamber. During the continuous curvilinear capsulorhexis, gradual intense staining of the filtering bleb was observed as the ICG dye passed into the bleb (Video 1). Uneventful cataract extraction by phacoemulsification was subsequently performed with in-the-bag implantation of a posterior chamber single-piece monofocal hydrophobic acrylic IOL (Acrysof IQ model SN60WF, Alcon Laboratories, Inc.).On the first postoperative day, the corrected distance visual acuity and IOP in the right eye were 20/25 and 8 mm Hg, r...

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