Background: Capsulorrhexis may be hazardous in the absence of the red fundus reflex. Anterior capsule trypan blue staining enabled to perform the capsulorrhexis and safe phacoemulsification.
Material and methods: Twenty patients with mature cataract were enrolled in the study and opereted on after injection of trypan blue in the anterior chamber.
Results: Circular capsulorrhexis was performed in all cases followed by phacoemulsification and in-the-bag IOL implantation. In two cases hard nuclei required a manual extracapsular technique. No operative complications, and no residual of coloration was noted the day after the operation. With a follow-up of 2 to 12 months, no complications appeared (cornea, capsulorrhexis, IOP).
Conclusion: In mature cataracts, with no red fundus reflex, capsulorrhexis can be done by anterior capsule staining.