Effect of trypan blue staining on the elastic modulus of anterior lens capsules of diabetic and nondiabetic patients

PURPOSE: To determine whether trypan blue causes a significant difference in the biomechanical properties (stiffness) of diabetic and nondiabetic anterior lens capsules and to determine whether diabetes significantly alters the stiffness of anterior lens capsules. SETTING: Veterans Administration Boston Healthcare Center System, Jamaica Plain, Massachusetts, USA. METHODS: In this unmasked prospective randomized controlled experimental study, anterior lens capsules were obtained from diabetic and nondiabetic patients approved for cataract surgery. Four treatment groups were created: (1) capsules of nondiabetic patients without trypan blue; capsules of nondiabetic patients with trypan blue; (3) capsules of diabetic patients without trypan blue; (4) capsules of diabetic patients with trypan blue. Anterior lens capsule stiffness as a function of elastic (Young's) modulus (kilopascals) was measured with the Hysitron TriboIndenter. RESULTS: The use of trypan blue led to significantly stiffer anterior lens capsules (P = .036). Trypan blue had the greatest effect on the stiffness of diabetic lens capsules (P = .046). CONCLUSION: Trypan blue contributed to increased capsule stiffness during capsulorhexis, especially in diabetic patients.

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