Hydrophilic acrylic IOLs show marked dye uptake

Dyes should be used with caution in surgery with hydrophilic acrylic IOLs because the dyes can discolor this type of lens, a group of researchers found. Trypan blue, indocyanine green and fluorescein sodium caused staining of hydrophilic acrylic IOLs but no other IOL materials tested, the researchers said.

A. Osman Saatci, MD, and colleagues at Dokuz Eylul University in Izmir, Turkey, bathed IOLs in the three dyes to determine their interactions with different materials. The types of IOLs evaluated were PMMA, silicone, three-piece hydrophobic acrylic, one-piece hydrophobic acrylic and one-piece hydrophilic acrylic. One IOL of each type was bathed in trypan blue 0.1%, fluorescein 2% and indocyanine green 0.5% for 15 minutes. Digital photos were taken before IOL bathing and after the 15-minute bath for each IOL. The IOLs were then dipped in the dyes again to ascertain the 30-minute dye uptake results.

If after the initial 15-minute bath the IOLs showed visible color change, they were then bathed in twofold dilution. If a color change was still seen, the lenses were bathed in a fourfold dilution. Digital photographs were processed to determine mean luminosity and red-green-blue values. Washout of the dyes was observed in vials containing serum.

The PMMA, silicone and hydrophobic acrylic IOLs were not stained by the dyes. The only IOLs that changed color were the hydrophilic acrylic lenses. All three dyes caused color changes in this lens material, the authors noted. Fluorescein sodium 2% and trypan blue 0.05% stained the lens most markedly, the authors said. Both twofold and fourfold dilutions of fluorescein sodium and ICG stained the hydrophilic lens. The fourfold dilution of trypan blue did not cause a significant color change. The trypan blue stain was washed out in 6 hours; the ICG stain remained for more than 24 hours.

The study is published in Ophthalmologica.