Cystoid macular oedema with trypan blue use.

We present a large comparative series of trypan blue use in cataract surgery. This series of trypan blue used in all eyes regardless of cataract severity may be unique. We found an apparent increased rate of cystoid macular oedema (CMO) associated with trypan blue use. Melles et al’s report on the use of trypan blue in cataract extraction in 1999 combined with Apple et al’s series on dye enhanced cataract surgery facilitated widespread acceptance of this technique. The dye has been shown to stain basement membrane of lens capsule. Trypan blue is now widely used to assist in cataract extraction when visualisation of the anterior capsule is poor because of loss of red reflex. Trypan blue has also been used to improve contrast during cataract extraction in eyes with corneal opacities and to stain internal limiting membrane and epiretinal membrane during vitreoretinal surgery. 8 The safety profile of trypan blue appears good with no adverse effects reported in several large series.