台盼蓝囊膜染色剂在复明工程成熟期白内障手术撕囊中的应用

目的 探讨台盼蓝囊膜染色剂在白内障复明工程白内障手术撕囊中的应用价值。设计 回顾性比较性病例系列。研究对象 2012-2013年期间河北省兴隆县人民医院“百万贫困白内障患者复明工程” 成熟期或过熟期白内障手术患者84例（84眼）。方法 随机分为观察组和对照组,每组42例（42眼）。观察组超声乳化白内障手术过程中接受0.1 ml 0.1%台盼蓝磷酸盐缓冲溶液前囊膜染色后行连续环形撕囊,对照组超声乳化白内障术中撕囊前未予染色。主要指标  术中囊膜染色情况,撕囊成功率,术后视力、眼压、前房炎症反应、角膜水肿及后囊混浊情况。结果 观察组台盼蓝染色后,晶状体前囊膜100%被染成淡蓝色。撕囊成功率观察组97.6%,对照组78.6%（P=0.003）;术后1个月视力、眼压、前房炎症反应、角膜水肿情况两组比较差异无统计学意义（均为P>0.05）;术后3个月后囊膜明显混浊观察组1/42例、对照组6/42例（P=0.027）。结论 白内障复明工程成熟期或过熟期白内障手术中采取台盼蓝囊膜染色剂行前囊膜染色,使连续环形撕囊相对容易,保证手术更顺利进行。（眼科,2014,23：271-273）     

台盼蓝在白色白内障超声乳化术中的应用

目的 探讨台盼蓝对晶状体前囊染色在白色白内障手术中应用效果。方法82例87眼随机分为染色组43例46眼与对照组39例41眼，染色组术中用台盼蓝染色，观察前囊膜着色效果、撕囊成功率、在超声乳化术中囊膜保护的完整率以及术中、术后并发症等，并与对照组进行统计学分析。结果染色组前囊膜均均匀着色，撕囊成功率与术中囊膜完整率均为100％，与对照组比较有明显统计学差异；术后视力、眼压、炎症反应、角膜内皮水肿与对照组比较无统计学差异。结论台盼蓝染色是一种简单安全的晶状体前囊膜染色技术，提高了前囊膜的可见度，有助于白色白内障超声乳化术连续环形撕囊术(continuous curvilinear capsulorhexis,COC)和整个手术的顺利进行。     

白内障手术连续环形撕囊的染色技术

目的:观察VisionBlue（0.06％台盼蓝）染色在白色白内障超声乳化手术中是否有助于连续环形撕囊（CCC）及整个手术安全顺利进行。方法:30例30只眼,术中前房注入0.1ml VisionBlue,观察前囊膜着色效果、撕囊成功率、在超声乳化手术中囊膜保护的完整率以及角膜内皮、眼压和房水炎症反应等。结果:28眼前囊膜周边及中央一次性均匀着色,2只眼经过两次染色后着色均匀;撕囊全部成功顺利,在后续的超乳手术中保留的囊膜边界清晰,完整率30/30;术中无并发症,术后视力提高,炎症反应轻,眼压及角膜内皮与术前无统计学差异;追踪3个月未见明显副作用。结论:VisionBlue染色是一种简单安全的技术,提高了前囊膜的可见度,有助于白色白内障超声乳化手术CCC和整个手术的安全顺利进行。     

改良亚甲蓝和台盼蓝前囊染色在白色白内障撕囊术中的临床应用对比

目的 探讨晶状体超声乳化术中改良亚甲蓝染色和台盼蓝染色对连续环形撕囊成功牢及对角膜内皮的影响.方法 67例(67眼)白色白内障(术中无红光反射者)随机分为3组进行前瞻性研究.改良亚甲蓝染色组25例,台盼蓝染色组24例,对照组(前囊不染色)18例.连续环形撕囊后行超声乳化及人工晶状体植入术.比较环形撕囊成功率、术中并发症、术后前房反应情况、视力、眼压、角膜内皮损失率及变异系数.结果 两种方法染色后撕囊成功率及人工晶状体囊袋内植入牢均为100.00%,无后囊破裂,与对照组相比差异有统计学意义;染色组术后视力高于对照组,但差异无统计学意义;3组术后眼压及角膜内皮损失率和变异系数筹异均无统计学意义.结论 改良亚甲监染色和台盼蓝染色均可明显提高连续环形撕囊成功率,降低超声乳化手术并发症,且无明显副作用,前者廉价易得,使用效果与台盼监相同.     

吲哚青绿在白色白内障连续环行撕囊手术中应用的研究

目的 探讨吲哚青绿囊染色剂在白色白内障环行撕囊术中的作用、安全性、有效性以及手术技巧.方法 对120眼白色自内障施行晶状体超声乳化手术,用0.5%吲哚青绿前囊染色后,再做连续环行撕囊.65眼先在前房内注入黏弹剂透明质酸钠,在黏弹剂下进行前囊染色;55眼在前房内注入0.5%吲哚青绿置换房水,再注入空气泡充盈前房在气泡下染色.结果 经0.5%吲噪青绿溶液染色后120眼白色白内障的前囊呈现淡绿色,能见度得到显著提高,117眼撕囊成功(97.50%).术后裂隙灯显微镜下未见染料残存,未见与染色有关的角膜内皮细胞损害、虹膜炎或眼压升高等并发症.结论 白色白内障连续环行撕囊术中应用0.5%吲哚青绿溶液前囊染色安全、有效,提高了白色自内障手术的成功率.     

台盼蓝染色技术在白内障超声乳化术中的应用

目的 观察在缺乏眼底红光反射的白内障超声乳化术中晶状体前囊膜台盼蓝染色技术的安全性及有效性。方法 对30例（30只眼）成熟期及过熟期白内障患者行超声乳化白内障吸除联合人工晶状体植入术,术中以0．1％的台盼蓝进行前囊膜染色,然后行连续环形撕囊术,观察术中情况,术后随访3个月,观察视力、眼压、角膜及房水情况。结果 30例白内障术中29例撕囊口边缘清晰可见．连续环形撕囊获得成功,手术顺利完成。1例术中囊膜染色不充分,囊口出现放射状撕裂,经补救撕囊．手术得以顺利进行。术后随访未发现与染色有关的眼部并发症。结论 在缺乏眼底红光反射的白内障超声乳化术中,以台盼蓝进行晶状体前囊膜染色后再行连续环形撕囊术是安全有效的方法。     

前囊膜染色在白色白内障连续环形撕囊中的应用

目的 探讨白色白内障连续环形撕囊术中前囊膜染色的方法。方法 对128眼白色白内障施行超声乳化手术．用0．1％台盼蓝（trypanblue）前囊膜染色后．再做连续环形撕囊。58眼先在前房内注入空气泡，置换房水，在气泡下进行前囊膜染色：70眼在前房内先注入弥散性强的黏弹剂，应用特制的前囊膜染色针头（其末端封塞．出孔位于近末端弯曲面下方）．在黏弹剂下进行前囊膜染色。结果 12．8眼均获得满意的前囊膜着色。在气泡下染色前囊膜．同时伴有角巩膜隧道切口、辅助穿刺切口和虹膜隐窝着色。19眼染色过程中前房气泡逃逸，其中，4眼局部角膜内皮细胞着色。在黏弹剂下行前囊膜染色，术中前房稳定，无角膜内皮细胞着色．无角巩膜隧道切口、辅助穿刺切口和虹膜隐窝着色。结论 白色白内障的眼底红光反射缺失．连续环形撕囊操作困难。通过前囊膜染色增加了前囊膜与其下晶状体皮质的对比度．应用特制的前囊膜染色针头，在黏弹剂下行前囊膜染色，简单便捷，使前囊膜染色范围更具可控性．减少了染色剂对眼内其他组织的潜在损伤。     

台盼蓝染色在白色白内障超声乳化术中应用的改进

目的观察低浓度的蓝域Vision Blue(0．03％台盼蓝)染色在白色白内障超声乳化术中对于连续环行撕囊术的帮助及整个手术是否安全顺利进行。方法43例43眼白色白内障在术中用0．1ml蓝域稀释为．0．2ml直接注入前房，观察晶状体前囊膜染色情况及术中、术后情况。结果43例43眼晶状体前囊膜均一次性均匀着色，连续环行撕囊术均顺利完成，术中、术后无不良反应。结论低浓度的蓝域染色是一种有效的晶状体前囊膜染色技术，能有效提高前囊膜能见度，有利于白色白内障超声乳化术的顺利进行。     

台盼蓝在白内障超声乳化手术中的应用

在成熟期白内障和缺乏良好红光反射的白内障超声乳化手术过程中,完成连续环形撕囊很困难,应用一定浓度的台盼蓝进行前囊膜的染色可以很好辨清前囊膜的位置,帮助准确完成连续环行撕囊,减少术中并发症的出现,现将台盼蓝在白内障超声乳化手术中的应用做一综述。     

扭动超声乳化加囊膜染色在成熟期白内障摘除术的疗效观察

目的观察扭动超声乳化加囊膜染色在成熟期白内障摘出术中的应用。方法将80例（128眼）成熟期白内障患者随机分为A、B两组,其中A组40例（66眼）行扭动超声乳化白内障摘除术。B组40例（62眼）行传统超声乳化白内障摘除术,术中采用吲哚青绿行前囊染色后撕囊,术中观察前房稳定性,能量释放及时间,术后第1、3、7天观察角膜水肿、前房反应和视力情况。跟踪角膜内皮细胞变化。结果术中连续环形撕囊（CCC）成功率为96.8%,A组前房稳定性优于B组（〈0.05）;术中能量使用及超声时间明显少于B组,术后第1、3、7天时A组角膜水肿情况明显少于B组（〈0.05）;术后第1、3天A组视力恢复明显好于B组（〈0.05）。结论扭动超声乳化加囊膜染色在成熟期白内障摘除术应用是安全且高效、疗效好的手术方式,尤其对于成熟期中硬核白内障的处理,优于传统超声乳化白内障摘出术。     

低浓度台盼蓝囊膜染色技术在白内障手术中的应用

目的：探讨台盼蓝染色晶状体前囊膜的最低有效浓度,评价白内障手术中应用囊膜染色技术的临床意义。

方法：收集2014-03/2016-12成熟期年龄相关性白内障患者60例60眼,晶状体皮质混浊程度为C4～C5、核混浊程度为N3(以晶状体混浊分类系统Ⅱ为标准),随机分为三组。三组患者术中分别使用0.03%、0.015%和0.0075%三种不同浓度台盼蓝。所有患者均由同一经验丰富手术医生完成手法小切口白内障手术。术中观察前囊膜染色情况以及撕囊难易程度。记录连续环形撕囊术(continuous circular capsulorhexis,CCC)成功、后囊袋破裂以及人工晶状体囊袋内植入情况。观察术后1d,1wk,3mo术眼角膜内皮细胞计数、眼压、前房炎症反应、角膜水肿和眼内结构染色情况。

结果：浓度低至0.015%的台盼蓝仍可对晶状体前囊膜有效染色,顺利完成CCC。0.03%与0.015%两组患者CCC成功率和IOL囊袋内植入率均高于0.0075%组,差异均有统计学意义(P<0.0083)。三组患者后囊破裂发生率和角膜内皮细胞平均损失率两两比较,差异均无统计学意义(P>0.0083)。术后晶状体前囊撕囊口边缘及侧切口的着染均于1wk内消失,未见其他眼内结构蓝染,前房炎症反应轻,未发现超过1wk的角膜水肿和眼压升高。

结论：白内障手术中应用台盼蓝晶状体前囊膜染色技术安全有效,可提高手术成功率,建议使用台盼蓝最低有效浓度为0.015%。     

Anterior capsule staining for capsulorhexis in cases of white cataract: comparative clinical study

PURPOSE: To compare the safety and efficacy of trypan blue 0.1%, gentian violet 0.001%, indocyanine green 0.5% (ICG), fluorescein 2%, and the patient's autologous blood for anterior capsule staining in cases of white cataract. SETTING: Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. METHODS: Fifty eyes of 50 patients with age-related white cataract had anterior capsule staining with trypan blue, ICG, or gentian violet under an air bubble or subcapsularly with fluorescein or autologous blood followed by phacoemulsification with foldable intraocular lens implantation. Each stain was used in 10 eyes. The ease of creating a continuous curvilinear capsulorhexis (CCC) and the complications during the surgery were noted. Postoperative examinations at 6 hours, 1 day, 1 week, and 1 month included slitlamp microscopy, uncorrected visual acuity, and best corrected visual acuity (BCVA). The staining patterns on the anterior capsule, side port, corneal tunnel, and anterior cortex were assessed intraoperatively and within 6 hours and at 1 day. The intraocular pressure (IOP) was assessed at 1 day; pachymetry, at 1 day and 1 month; and the endothelial cell count, at 1 month. RESULTS: The surgeon had best visualization during the anterior capsulorhexis with trypan blue, ICG, and gentian violet, and a complete CCC was achieved in all eyes in the 3 groups. Two eyes each in the fluorescein and autologous blood groups had extension of the CCC so that the capsulorhexis was complete but not curvilinear. Anterior capsule fibrosis was detected with trypan blue (1 eye) and ICG (2 eyes). The anterior vitreous was stained with fluorescein in 2 eyes. All eyes achieved a BCVA of 20/30 or better from 1 week postoperatively to the last follow-up. The side port and corneal tunnel were stained most intensely with gentian violet followed by trypan blue and ICG and less intensely with fluorescein and autologous blood. The IOP, pachymetry, and endothelial cell loss were comparable between the stains. CONCLUSION: Although trypan blue, ICG, gentian violet, fluorescein, and autologous blood were safely used to stain the anterior capsule for phacoemulsification in eyes with white cataract, trypan blue, ICG, and gentian violet were more effective in staining the capsule.     

Results of surgery on white cataract using trypan blue capsule staining to visualize capsulorrhexis

PURPOSE: To evaluate surgery on white cataracts using trypan blue capsule staining. METHODS: A retrospective study comprised 64 eyes of 60 patients with white cataract that had surgery with trypan blue capsule staining. The average age was 62.4 years and progress observation periods were 5.6 months. The rate of successful continuous curvilinear capsulorrhexis(CCC), complications, visual acuity, intraocular pressure(IOP), flare value, and corneal endothelial cell loss were studied. RESULTS: The CCC was completed uneventfully in 93.8% eyes. Posterior capsule rupture occurred in 2 eyes, and early perforation in 1 eye. Accidental vitreous staining and endothelial staining with trypan blue were observed in 1 eye each. There were no postoperative complications associated with trypan blue. Forty-five eyes had a best corrected visual acuity of 0.8 or better at the last visit. Twelve eyes had some ocular pathology resulting in visual loss, and a reliable visual acuity test could not be performed in 6 eyes. The mean postoperative IOP was within the normal range. The mean postoperative flare returned to within normal range 1 month after surgery. The mean corneal endothelial loss was 13.7%, and that of eyes with nucleus of grade 2 or softer was only 2.9%. CONCLUSIONS: Cataract surgery using trypan blue was safe and effective in managing white cataracts.     

Severe toxic effect of methylene blue 1% on iris epithelium and corneal endothelium

PURPOSE: To report a case of corneal endothelial decompensation and iris pigment dispersion following the inadvertent use of methylene blue 1% for capsular staining during cataract surgery. DESIGN: Case report. METHODS: During an otherwise routine phacoemulsification cataract surgery, inadvertent anterior capsule staining with methylene blue 1% instead of trypan blue 0.025% was performed. Copious irrigation of the anterior chamber with balanced salt solution was initiated upon identification of the wrong dye. The operation was completed with minimal ultrasound energy without complications. RESULTS: Iris discoloration and severe corneal edema developed in the early postoperative period, resulting in severe visual loss. The patient developed bullous keratopathy and underwent penetrating keratoplasty 16 months later. CONCLUSIONS: In vivo intracameral injection of methylene blue 1% induces extreme cytotoxicity, primarily on the corneal endothelium and iris epithelium.     

Staining the Anterior Capsule with Indocyanine Green or Trypan Blue for Capsulorhexis in Eyes with White Cataract

Aim: To assess the efficacy and safety of indocyanine green (ICG) 0.5% and trypan blue 0.1% for anterior capsule staining in cases of white cataract. Methods: This prospective study comprised 55 eyes of 55 patients with white cataract that had phacoemulsification with foldable intraocular lens implantation. ICG in 30 eyes and trypan blue in 25 eyes were used under air to stain the anterior lens capsule. The staining patterns and the ease of creating a continuous curvilinear capsulorhexis (CCC) were assessed; the intraoperative and postoperative complications were noted. The mean follow-up was 17.68±1.65 months. Result: Either ICG or trypan blue stained the anterior capsule uniformly. However, the staining provided by trypan blue was slightly superior. A CCC was successfully achieved in 25 eyes (100%) with trypan blue, and 29 eyes (96.7%) with ICG, respectively. There was no significant postoperative reaction in any eye. Conclusion: The use of vital dyes such as ICG and trypan blue guarantees a complete CCC and makes it possible to deliver the benefits of phacoemulsification in the patients with white cataract.     

台盼蓝囊膜染色剂在白内障连续环形撕囊手术中的应用

目的研究台盼蓝囊膜染色剂在治疗白色白内障中,是否有助于连续环形撕囊的顺利完成及白内障手术的顺利进行。方法79例(80眼),随机分为2组,染色组40例(41眼),对照组39例(39眼),染色组使用台盼蓝囊膜染色剂,术中观察及对比前囊膜染色情况、连续环性撕囊成功率、晶状体后囊破裂及人工晶状体囊袋内植入情况,术后视力、前房炎症反应、角膜、人工晶状体有无蓝染及后囊混浊情况。并与对照组进行统计学分析。结果染色组的术中染色均匀,连续环形撕囊及人工晶状体囊袋内植入率为97.7%,晶状体后囊破裂率为2.44%,与对照组进行统计学分析有显著差异。术后追踪观察3个月,染色组术后视力好于对照组,前房炎症反应、晶状体后囊混浊2组无统计学差异。染色组术后角膜、人工晶状体未见蓝染,未见术中及术后并发症。结论台盼蓝囊膜染色剂目前是一种安全可靠的技术,手术中可以看清前囊,使连续环形撕囊顺利进行,人工晶状体稳定的位于囊袋内,增加了白色白内障手术的成功率。     

台盼蓝在全白或过熟期白内障手术连续环形撕囊前的应用观察

目的:探讨台盼蓝在全白或过熟期白内障手术连续环形撕囊前的应用观察.方法:选取近3a在我院眼科住院手术的全白或过熟期白内障患者42例42眼,术中均于前房内注入0.6mg/mL台盼蓝约0.2mL,使前囊膜着色成淡淡的蓝色,后进行连续环形撕囊.记录术前,术后1wk,1mo不同时段角膜内皮细胞密度及角膜内皮六角形细胞比例,并对其进行重复测定方差分析.结果:台盼蓝染色后,所有术眼均顺利完成连续环形撕囊,为下一步手术鉴定了成功的基础.术前,术后lwk,1 mo不同时段记录的角膜内皮细胞密度和角膜内皮六角形细胞比例差异无统计学意义.结论:对于过熟期及全白等难度较大的白内障手术,用台盼蓝染色前囊膜后,连续环形撕囊更易行、更安全.