Modified 30 G needle trypan blue staining technique under air for a uniform and consistent anterior capsule staining

Figures & data

Table 1 Modified 30 G needle technique – relation with chamber stability, staining uniformity, dye spilling into vitreous cavity, and making of red reflex

N=1,000	Chamber stability	Staining uniformity	Dye spilling into vitreous cavity	Masking of red reflex
Variant 1 (one drop of TB)
557	557	557	0	12
Variant 2 (air prefilled)
281	281	281	0	21
Variant 3 (selective painting)
162	162	162	0	0

Abbreviation: TB, trypan blue.

Figure 1 Homogenous staining pattern after TB dye staining.

Notes: Postoperatively, all patients had normal intraocular pressure. Examination on slit-lamp revealed mild to moderate inflammation. All the cases responded well to the postoperative topical steroid and cycloplegic eye drops by day 14. There was no residual TB stain seen on day 1. The mean postoperative endothelial cell loss was 9.4%.
Abbreviation: TB, trypan blue.

Table 2 Staining intensity with modified 30 G needle technique

Staining intensity/uniformity	Number of cases (n=1,000)	Percentage
Poor	0	0
Fair	0	0
Good	192	19.2
Excellent	808	80.8

Table 3 Comparison of various staining techniques^3–7,20

Technique	Costing	Difficulty level	Staining uniformity	Direct application of TB	Amount of dye	Time consumed	Endothelial toxicity	Spilling into posterior segment	Safety	AC stability	AC visibility	Iatrogenic trauma
Melles et al^Citation3	Cost-effective	Easy	Patchy	Yes	Moderate	Less	Maybe	Maybe	Very safe	Poor	Moderate	Moderate chances
Laureano and Coroneo^Citation4	Cost-effective	Easy	Patchy	Yes	Large	Less	Maybe	Maybe	Some probability of anterior capsule trauma	Poor	Poor	Moderate chances
Mearza and Kulkarni^Citation5	Cost-effective	Easy	Patchy	Yes	Large	Less	Maybe	Maybe	Some probability of anterior capsule trauma	Poor	Poor	Moderate chances
Arshinoff^Citation6	Higher cost	Difficult	Moderate	Yes	Moderate	More	Nil	No	Very safe	Good	Moderate	Minimal chances
Marques et al^Citation7	Higher cost	Difficult	Moderate	Yes	Moderate	More	Nil	No	Very safe	Good	Moderate	Minimal chances
Giammaria et al^Citation20	Cost-effective	Easy	Moderate	Yes	Minimal	Less	Nil	No	Some probability of anterior capsule trauma	May or may not be there	Very good	Moderate chances
Our technique	Cost-effective	Easy	Good	Yes	Minimal	Less	Nil	No	Very safe	Good	Very good	Minimal chances

Abbreviations: AC, anterior chamber; TB, trypan blue.

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