TRYPAN BLUE MIGRATION IN THE VITREOUS DURING PHACOEMULSIFICATION

To present an unusual intraoperative complication associated with the use of trypan blue dye during phacoemulsification.

E. Patsidis Day Case Unit, Larissa (Greece)

Video presentation of inadvertent trypan blue dye migration from the anterior chamber to the vitreous cavity during phacoemulsification of a young myope, semi-professional football player without a previous history of zonular compromise, trauma or pseudoexfoliation. The subsequent management of this rare complication and the outcome are also presented.

Following the migration of trypan blue in the vitreous cavity, the surgeon successfully completed continuous curvilinear capsulorhexis and lens phacoemulsification despite the absolute absence of red reflex. The eye was left temporarily aphakic. Subsequently, a 25g pars plana vitrectomy was immediately undertaken. The trypan blue dye was evacuated from the vitreous cavity and the procedure was concluded with the planned implantation of a single piece toric intraocular lens. The patient had an uneventful post-operative course and eventually achieved a satisfactory refractory result.

There are scarce reports in the literature of trypan blue migration in the vitreous cavity through intact zonules during phacoemulsification. In the presented case it is postulated that the combination of myopia and small but repetitive head traumas associated with football is the culprit of subclinical zonular compromise leading to dye migration in the vitreous cavity. In this context, prompt and minimally invasive management can accomplish an excellent functional outcome.