Methylene blue-related corneal edema and iris discoloration

We report the case of a 70-year-old female patient who developed corneal edema and iris discoloration following the inadvertent use of 1% methylene blue instead of 0.025% trypan blue to stain the anterior capsule during cataract phacoemulsification surgery. Copious irrigation was performed upon real...

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Bibliographic Details
Published in:Arquivos brasileiros de oftalmologia 2016-04, Vol.79 (2), p.121-122
Main Authors: Timucin, Ozgur Bulent, Karadag, Mehmet Fatih, Aslanci, Mehmet Emin, Baykara, Mehmet
Format: Article
Language:English
Subjects:
Aged
Coloring Agents - administration & dosage
Coloring Agents - adverse effects
Coloring Agents - pharmacology
Corneal Edema - etiology
Female
Humans
Injections
Iris - drug effects
Medical Errors - adverse effects
Methylene Blue - administration & dosage
Methylene Blue - adverse effects
Methylene Blue - pharmacology
OPHTHALMOLOGY
Phacoemulsification - adverse effects
Phacoemulsification - instrumentation
Therapeutic Irrigation - methods
Visual Acuity
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Summary:We report the case of a 70-year-old female patient who developed corneal edema and iris discoloration following the inadvertent use of 1% methylene blue instead of 0.025% trypan blue to stain the anterior capsule during cataract phacoemulsification surgery. Copious irrigation was performed upon realization of incorrect dye use. Corneal edema and iris discoloration developed during the early postoperative period and persisted at 24-months follow-up. However, keratoplasty was not required. The intracameral use of 1% methylene blue has a cytotoxic effect on the corneal endothelium and iris epithelium. Copious irrigation for at least 30 min using an anterior chamber maintainer may improve outcomes.
ISSN:0004-2749
1678-2925
1678-2925
DOI:10.5935/0004-2749.20160036