New stains for anterior capsule surgery

Wilińska, Joanna; Mocanu, Bianca; Awad, Doaa; Gousia, Dimitra; Hillner, Charlie; Brannath, Werner; Mohr, Andreas; Gabel, Detlef

doi:10.1016/j.jcrs.2018.09.016

Cited by 5 publications

(13 citation statements)

References 19 publications

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“…Although the thickness of the porcine anterior lens capsule is thinner than that in humans, 20 , 21 semiquantification of the capsule staining intensity can be determined. Thus our current results indicate that an effectiveness score, such as that previously described by Wilińska et al (2019), 7 can be assigned to the tested dyes using microscopic studies of the lens.…”

Section: Discussionsupporting

confidence: 80%

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Ex-Vivo Method to Quantifiably Evaluate the Staining Effectiveness of Anterior Lens Capsule Dyes

Fernandez-Bueno

Pastor

Andrés-Iglesias

2021

Trans. Vis. Sci. Tech.

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Purpose High frequency of cataracts and the requirements of new European Union regulations for medical devices require the availability of preclinical models to adequately evaluate anterior lens capsule dyes before their use in patients. Herein, we describe an ex vivo method to quantifiably evaluate the macroscopic and microscopic staining effectiveness of anterior lens capsule dyes using porcine eyes. Methods Commercially available trypan blue–based products or physiological saline solution (negative control) was injected into porcine eyes. Anterior pole and lens (after extraction) were macroscopically photographed, and the images were quantitatively analyzed. Lenses were histologically processed, and the staining intensity microscopically was semiquantified. Results Macroscopic evaluation of the anterior pole revealed bluish staining of the anterior capsule; however, this coloring cannot be macroscopically discerned after lens extraction. Quantitative image analyses showed significant ( P < 0.01) staining of the lens capsule compared to the negative control, but not significant ( P > 0.05) between the products tested. Quantitative analysis of dying on lens images could not be performed. Microscopic semiquantification of the capsule staining intensity allows us to appreciate differences between products. Conclusions The described method is a quick and useful tool for macroscopic evaluation by surgeons to choose an anterior capsule staining for use during everyday surgeries, and a more specific microscopic evaluation also allows us to determine the effectiveness and usefulness of these products. Translational Relevance This method satisfies preclinical effectiveness evaluations required by European Union regulations and complements the safety and toxicity evaluations that new products must guarantee before they enter the market and are used in clinical practice.

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Section: Discussionsupporting

confidence: 80%

“…Finally, a comparative analysis of the acquired microscopic images was performed. Thus the staining intensity was semiquantified according to the following scale previously described 7 : no staining (negative control), baseline (positive control), less intense than baseline, or more intense than baseline.…”

Section: Methodsmentioning

confidence: 99%

Ex-Vivo Method to Quantifiably Evaluate the Staining Effectiveness of Anterior Lens Capsule Dyes

Fernandez-Bueno

Pastor

Andrés-Iglesias

2021

Trans. Vis. Sci. Tech.

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“…This might be attributed to the young age of the animals. We could demonstrate the presence of remaining vitreous, as it can be stained with a dye evaluated by us for use in anterior chamber surgery 9…”

Section: Discussionmentioning

confidence: 99%

“…We could demonstrate the presence of remaining vitreous, as it can be stained with a dye evaluated by us for use in anterior chamber surgery. 9 In summary, we have been able to prepare a new formulation of dyes for vitreoretinal surgery to bridge the need between the translucent ILM-selective stains BBG and (off-label) ICG and the ERM-staining by TB, with improved properties over available dye combinations. Further studies in patients will show whether the new formulation is safe, while maintaining sufficient staining for the surgical procedure.…”

Section: Patient Consent For Publication Not Applicablementioning

confidence: 99%

New dual dye for vitreoretinal surgery with increased transparency

et al. 2022

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ObjectivesTo develop a new dye formulation for vitreoretinal surgery, which shows increased transparency for better intraoperative handling with better parameters important for use.Methods and analysisA new blue dye, DDG, was synthesised and tested for toxicity and staining. Diglycerol as new density-increasing additive was identified, and its toxicity and lack of influence of the staining with trypan blue (TB) on a collagen membrane as model for the epiretinal membrane was determined. Transparency of the dye solution was evaluated.ResultsDDG is as alternative to Brilliant Blue G (BBG), with good staining properties for interna limitans models, and a good safety profile. Diglycerol is a new non-toxic additive replacing PEG3350, with reduced viscosity and no reduction in staining, allowing the reduction of TB to achieve the same staining level of the collagen membrane by 40%, with greater transparency of the dye solution and reduced viscosity. Both factors should facilitate a safe removal during surgery.ConclusionA new dye preparation with improved performance in comparison to marketed combinations of BBG and TB was developed. Its reduced TB concentration and viscosity with maintained density allow better tolerance and handling.

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“…TB is a widely used vital dye whose efficacy in terms of staining properties and cytotoxicity on various structures of the anterior segment of the eye has been investigated in several in vitro studies 2,3,11,12 and clinical trials 4,[13][14][15][16] .TB showed no cytotoxic effects in clinical studies, but in vitro studies proved that TB is toxic to cultured human corneal endothelial cells, 11 cultured rabbit corneal endothelial cells 2 or HeLa cells in a concentration-and/or time-dependent manner. 12 Basically, the use of TB requires a rapid rinsing of stained areas and a complete removal from the eye, as the critical concentration might be exceeded due to the weak miscibility in the eye. In our opinion, the advantage of the investigated Pe-Ha-Blue®PLUS OVD is that the vital dye TB is present in a much lower concentration and bound in the matrix of a cohesive viscoelastic due to its mixing in the OVD and thus more even distribution in the eye.…”

Section: Discussionmentioning

confidence: 99%