Abdelmotaal Hazem, Abdelazeem Khaled, Hussein Mohamed S, Omar Ahmed F, Ibrahim Walid
Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.
J Ophthalmol. 2019 Mar 27;2019:4018739. doi: 10.1155/2019/4018739. eCollection 2019.
To study the potential corneal endothelial cell toxicity of trypan blue (TB) when used for phacoemulsification to stain the anterior capsule in patients with diabetic retinopathy.
This was a single-center, prospective, randomized, individual cohort study. One eye in each patient with diabetic retinopathy underwent phacoemulsification without trypan blue capsule staining (control eye), while the other eye underwent phacoemulsification with trypan blue capsule staining (study eye). Both eyes underwent intraocular lens implantation. Preoperative and four-week postoperative quantitative and qualitative morphometric endothelial cell analyses of the cornea were performed using noncontact specular microscopy.
There were no significant differences in endothelial cell density (mean ± SD for the study group: 2506.74 ± 413.99 cells/mm; mean ± SD for the control eyes: 2466.34 ± 369.12 cells/mm; =0.316) or endothelial cell density (CD) loss% (mean CD loss% was 7.23 ± 13.31 for the study eyes and 9.94 ± 9.36 for the control eyes; =0.157) four weeks after the operation. Additionally, no significant differences were seen in the percentage of hexagonal cells, coefficient of variation, or corneal thickness between the two groups preoperatively and 4 weeks postoperatively.
Direct administration of trypan blue into the anterior chamber for staining of the anterior capsule during cataract surgery did not result in any significant corneal endothelial changes on specular microscopy in patients with severe nonproliferative diabetic retinopathy or high-risk proliferative diabetic retinopathy at 4 weeks postoperatively. This trial is registered with NCT03755752.
研究锥蓝（TB）用于糖尿病视网膜病变患者白内障超声乳化术中对前囊膜染色时的潜在角膜内皮细胞毒性。
这是一项单中心、前瞻性、随机、个体队列研究。每位糖尿病视网膜病变患者的一只眼接受不使用锥蓝囊膜染色的超声乳化术（对照眼），而另一只眼接受使用锥蓝囊膜染色的超声乳化术（研究眼）。两只眼均植入人工晶状体。术前及术后四周使用非接触式镜面显微镜对角膜进行定量和定性形态学内皮细胞分析。
术后四周，内皮细胞密度（研究组均值±标准差：2506.74±413.99个细胞/mm；对照眼均值±标准差：2466.34±369.12个细胞/mm；P=0.316）或内皮细胞密度（CD）损失百分比（研究眼平均CD损失百分比为7.23±13.31，对照眼为9.94±9.36；P=0.157）均无显著差异。此外，两组术前及术后4周的六边形细胞百分比、变异系数或角膜厚度均无显著差异。
在白内障手术期间将锥蓝直接注入前房以对前囊膜进行染色，在术后4周时，对于重度非增殖性糖尿病视网膜病变或高危增殖性糖尿病视网膜病变患者，镜面显微镜检查未发现角膜内皮有任何显著变化。本试验已在NCT03755752注册。
