Trypan Blue for the Assessment of Filtering Bleb Function During Cataract Surgery.
Yung Edward S, Moster Marlene R, Sanvicente Carina, Pluta John, Rahmatnejad Kamran, Patel Arjun S, Williams Alice, Abramowitz Ben, Katz L Jay, Pro Michael
AI Summary
Trypan blue bleb staining during cataract surgery in prior trabeculectomy eyes was studied. Staining intensity did not predict post-operative IOP changes, suggesting limited clinical utility for assessing bleb function.
Abstract
Purpose
Phacoemulsification has been cited as a possible cause of bleb failure in eyes with prior trabeculectomy. No method has been developed to directly evaluate the risk of bleb failure after phacoemulsification. We investigate the use of trypan blue during cataract surgery in the setting of a preexisting trabeculectomy to evaluate the functional status of the bleb and predict postoperative bleb function.
Materials and methods
In total, 14 patients contributing 1 eye each with a history of prior trabeculectomy with mitomycin C undergoing phacoemulsification with intraocular lens implantation were enrolled in this prospective, nonrandomized clinical trial. At the time of phacoemulsification, trypan blue was instilled into the anterior chamber before capsulorhexis creation. Staining of the bleb was grouped as being mild or diffuse using intraoperative photographs. These eyes were followed for 1 year postoperatively and evaluated for intraocular pressure (IOP) control.
Results
The change in IOP was not significantly different between the 2 groups (P=0.14). A trend towards greater need for IOP-lowering medications was noted (P<0.10) in eyes with mild bleb staining. No statistically significant difference in rates of decreased bleb function was noted at 1-year follow-up after phacoemulsification.
Conclusion
The intensity of bleb staining with trypan blue during phacoemulsification is not associated with changes in IOP postoperatively. A trend towards decreased need for IOP-lowering medications was noted in eyes with diffuse bleb staining at 1 year after cataract surgery.
MeSH Terms
Shields Classification
Key Concepts5
The change in intraocular pressure (IOP) was not significantly different between eyes with mild bleb staining and eyes with diffuse bleb staining when trypan blue was used during cataract surgery in eyes with prior trabeculectomy (P=0.14).
A trend towards greater need for IOP-lowering medications was noted (P<0.10) in eyes with mild bleb staining compared to eyes with diffuse bleb staining when trypan blue was used during cataract surgery in eyes with prior trabeculectomy.
No statistically significant difference in rates of decreased bleb function was noted at 1-year follow-up after phacoemulsification in eyes with prior trabeculectomy, regardless of trypan blue staining intensity.
The intensity of bleb staining with trypan blue during phacoemulsification in eyes with prior trabeculectomy is not associated with changes in intraocular pressure (IOP) postoperatively.
A trend towards decreased need for IOP-lowering medications was noted in eyes with diffuse bleb staining at 1 year after cataract surgery when trypan blue was used during phacoemulsification in eyes with prior trabeculectomy.
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