Ophthalmic Dye — Capsule Staining (Cataract Surgery) Pregnancy: Intraoperative use — not applicable in standard pregnancy considerations

Trypan Blue 0.06% (Ophthalmic)

Brand names: VisionBlue, Membrane Blue

Adult dose

Dose: 0.1–0.5 mL of 0.06% solution injected under viscoelastic into anterior chamber

Route: Intracameral (anterior chamber injection during cataract surgery)

Frequency: Single intraoperative application

Max: 0.5 mL intraoperative

Injected under air or viscoelastic to stain the anterior lens capsule (capsulorrhexis facilitation) blue — critical for continuous curvilinear capsulorrhexis (CCC) in challenging cases (white cataracts, dense brunescent lenses). Contact time 30–60 seconds, then irrigated out.

Paediatric dose

Route: Intracameral

Frequency: Single intraoperative

Max: 0.5 mL

Paediatric cataract surgery — capsule staining in posterior capsulotomy and anterior capsulorrhexis; specialist paediatric ophthalmology use

Dose adjustments

Renal

No adjustment — intracameral use; negligible systemic absorption

Hepatic

No adjustment

Clinical pearls

White/mature cataract challenge: when the anterior capsule is white and opaque, the capsulorrhexis is extremely difficult without staining — trypan blue selectively stains the epithelial layer of the anterior capsule, making the edge visible for continuous circular tear
Safe injection technique: inject under air or viscoelastic (not balanced salt solution directly) to prevent contact with corneal endothelium — corneal endothelial toxicity has been reported with direct BSS dilution injection
Membrane Blue (ILM staining): a different preparation for internal limiting membrane (ILM) staining in vitreoretinal surgery — similar dye but different surgical context; do not confuse with VisionBlue (anterior capsule staining)
Brilliant Blue G (BBG) is an alternative for ILM staining in macular hole surgery — potentially safer than ICG for ILM staining with comparable visualisation
Phaco pearls: a 30-second contact time is sufficient for capsule staining; longer contact increases endothelial exposure risk unnecessarily

Contraindications

Direct injection into vitreous cavity — endothelial toxicity risk
Hypersensitivity to trypan blue

Side effects

Corneal endothelial toxicity if injected without viscoelastic protection
Transient blue discolouration of surrounding structures (resolves)

Interactions

No clinically significant drug interactions

Monitoring

Intraoperative: corneal clarity post-phacoemulsification
Postoperative: corneal oedema (endothelial assessment)

Reference: BNFc; BNF 90; ESCRS Cataract Surgery Guidelines; VisionBlue SPC; JCRS Review (Trypan Blue Safety). Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways