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Br J Ophthalmol 89:1152-1156 doi:10.1136/bjo.2005.071753
  • Clinical science
    • Extended reports

Trypan blue identifies antimetabolite treatment area in trabeculectomy

Table 1

 Characteristics and outcomes of 22 consecutive trabeculectomies with or without intraoperative trypan blue

Case/sex/age Diagnosis* Antimetabolite Pre-op IOP Pre-op meds IOP at 2 years Interventions† Complications‡ IOP reduction mmHg (%)
Diagnosis: OAG, open angle glaucoma; ACG, angle closure glaucoma; UG, uveitis glaucoma; TG, traumatic glaucoma.
*Case 13: sponges were placed dry and MMC was added via a syringe (see text).
†Interventions: 5-FU, subconjunctival 5-FU injection; needle, micropuncture of internal bleb walls with 30 gauge needle combined with 5-FU injection; meds, topical glaucoma medications recommenced; CE, cataract extraction.
‡Complications: choroidal effusions and wound edge leaks were transient and did not affect vision or require re-operation except for case 2 where wound resuturing was performed. Case 1: hyphaema was associated with oral NSAIDs taken for intercurrent illness. Month 3 wound leak of case 18 (other eye of case 14) was secondary to wound contraction.
No trypan blue
    1/M/69 OAG 5-FU 50 mg/ml 32 4 15 5-FU, needle Hyphaema, day 10 17 (53)
    2/M/58 TG 5-FU 50 mg/ml 50 0 18 5-FU Wound edge leak required resuture 32 (64)
    3/M/72 OAG MMC 0.4 mg/ml 44 2 11 None None 33 (75)
    4/M/69 OAG 5-FU 50 mg/ml 38 3 13 5-FU Choroidal effusion, week 1 25 (66)
    5/F/69 UG 5-FU 50 mg/ml 29 4 14 5-FU × 4, CE None 15 (52)
    6/F/57 OAG 5-FU 50 mg/ml 30 3 11 5-FU None 19 (63)
    7/M/80 OAG 5-FU 50 mg/ml 26 3 14 5-FU None 12 (46)
    8/F/70 UG MMC 0.2 mg/ml 16 4 9 5-FU None 7 (44)
    9/M/76 OAG MMC 0.2 mg/ml 22 3 18 5-FU, CE, 2 meds None 4 (18)
    10/M/64 ACG MMC 0.2 mg/ml 34 4 5 5-FU None 29 (85)
    11/M/79 OAG 5-FU 50 mg/ml 25 4 18 7 (28)
    Mean 31.45 3.09 13.27 18 (58)
Trypan blue
    12/F/71 OAG 5-FU 45 mg/ml 20 5 10 5-FU×2 None 10 (50)
    13*/M/58 OAG 5-FU 45 mg/ml 22 3 14 5-FU Choroidal effusion, wound edge leak, week 1 8 (36)
    14/M/55 ACG MMC 0.2 mg/ml 34 5 10 None None 24 (71)
    15/M/80 OAG 5-FU 45 mg/ml 28 1 8 5-FU×3, needle None 20 (71)
    16/F/85 UG MMC 0.2 mg/ml 27 2 6 None None 21 (78)
    17/M/55 NVG MMC 0.4 mg/ml 36 3 8 5-FU None 28 (78)
    18/F/80 OAG 5-FU 45 mg/ml 20 3 14 5-FU None 6 (30)
    19/M/56 ACG 5-FU 45 mg/ml 25 2 17 5-FU needle 2 meds Wound edge leak, month 3 8 (32)
    20/M/67 NTG 5-FU 45 mg/ml 8 4 10 5-FU None −2 (−25)
    21/M/72 OAG 5-FU 45 mg/ml 44 4 13 CE None 31 (70)
    22/M/65 OAG 5-FU 45 mg/ml 42 4 5 5-FU ×2 Circulating hyphaema, day 1 37 (88)
    Mean 27.82 3.27 10.45 17 (62)

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