effect of trypan blue anterior capsular stainning on lens epithelial cells: a histopathological study

The aim of the present study is to detect the histopathological impact of trypan blue dye on anterior capsular epithelial cells of the anterior capsules stained with trypan blue dye during phacoemulsification. Twenty cataractous eyes underwent anterior capsule staining using 1 mL typan blue dye 0.5%, under air as apart of a routine phacoemulsification of the cataractous lens. Anterior capsulorhexis was done and the obtained anterior capsule flaps were sent for histopathological examination. As a control group, 20 cataractous eyes underwent phacoemulsification without capsular staining and the flaps were sent for histological examination compareing the findings in both groups. The histopathological examination of the stained capsules demonstrate, focally ragged and irregular outer limit of the capsule with reduction of thickness and considerable loss of cells and change in the viability of the residual epithelial cells compared with the unstained capsules. Staining the anterior lens capsule during cataract surgery using the most popular trypan blue dye appears not only to facilitate capsular visualization but also can attack the lens epithelial cells, the main source for capsule opacification. Further studies and clinical correlation is mandatory to further evaluate the cytotoxic effect of the dye on different ocular structures and its effect on posterior capsule opacification

Preservative-free lidocaine 1%: a new approach for the prevention of posterior capsule opacification [PCO]: a clinical study

The aim of the present study is to detect the effect of preservative-free lidocaine 1% applied into the capsular bag by the end of phacoemulsification on the behaviour of posterior capsule opacification [PCO]. Thirty patients aged from 40-65 years [mean 52.2 +/- 6.38SD] presented by bilateral cataracts were included. Patients were randomly divided into two study groups; Group 1: Comprised 30 eyes in which 1.0 mL preservative-free lidocaine 1% was applied for irrigating the capsular bag before in the bag implantation. Group 2 [control group]: Comprised the fellow eyes [30 eyes] of the first group patients with no application of preservative-free lidocaine 1% during phacoemulsification. The mean follow-up period was 8.7 +/- 2.58 months, however 10 patients could achieved a follow-up period of 12 months. No intra-operative complications reported in both groups. A mild to moderate anterior segment reaction [flare + and ++] was reported in the early postoperative, with no statistical difference between both groups. An immediate spike of increased IOP was reported in 5 eyes [16.6%] of group 1 [Lidocaine group] and 4 eyes [13.3%] of group 2, however the mean postoperative IOP by the end of the follow-up period was 14.26 +/- 1.48 mm Hg and 13.86 +/- 1.5 mm Hg in both group 1 and 2 respectively, with no statistical differences between both groups. No major corneal complications reported in both groups and specular microscopic examination by the end of 6 months follow-up revealed no gross abnormalities. The mean post-operative endothelial cell count was 2742/mm3 +/- 534.81 with no statistical difference between both groups and the pre-operative count. Five eyes of group 1 [16.66%] treated with preservative free lidocaine 1% developed posterior capsule opacity detected by slit lamp examination at the end of the follow-up period with Nd:YAG posterior capsulotomy was applied for 2 eyes with dense PCO, however 10 eyes [33.33%] in group 2 [control group], developed posterior capsule opacification and Nd: YAG capsulotomy was applied to clarify the visual axis. Preservative-free lidocaine 1% might decrease the incidence and density of post-cataract posterior capsule opacification compared with eyes not treated with lidocaine intraoperatively with no major intraocular complications