Trypan Blue

Trypan blue is a dye used to help prepare patients for eye surgery.

Overview

Doctors use trypan blue as a surgical aid when you have cataract surgery on your eyes. It’s a blue dye that stains the retinal membrane. Consequently, this provides a contrast that lets your doctor see the various parts of the eye more clearly, particularly the retinal membrane.

Trypan blue is only available by prescription and is known by the following brand names.

  • Azidine blue 3B
  • Niagara blue 3B
  • Benzo Blue bB
  • Diamine blue 3B
  • MembraneBlue
  • Benzamine blue 3B
  • Chlorazol blue 3B
  • Direct blue 14
  • Dianil blue H3G
  • VisionBlue

Trypan blue is made from toluidine, an isomeric base of toluene. Trypan blue got its name from its ability to kill the parasites that cause sleeping sickness, trypanosomes. Niagara blue, also called suramin, is a derivative of trypan blue, used against trypanosomiasis. However, the main use of Trypan blue is in cataract surgery, where it’s used to stain the anterior capsule of your eye to make cataracts more visible. A mature cataract shows up clearly in trypan blue, so it makes an effective aid during preparation for the surgery.

Trypan blue, when used for cataract surgery, comes in a 2.25 mL syringe that holds a blunt cannula that dispenses the dye. With your eye open, the surgeon typically injects an air bubble into the front chamber of your eye. This is to prevent over-dilution of the dye by the aqueous solution in your eye. The staining occurs as soon as the trypan blue contacts the capsule of your eye. The anterior section is flushed with a salt solution to clear excess dye.

Sufficient staining is achieved as soon as the dye has contacted the capsule. The anterior chamber is then irrigated with balanced salt solution to remove all excess dye. An incision can then be made in the anterior capsule of the eye. This technique is called an anterior capsule staining technique. There is a second technique where the dye is injected under viscoelastic fluid in the eye.

When injected under an air bubble, a dye lake is created over the lens, which is more efficient and economical. However, it’s harder to maintain the correct depth and the dye can leak out more easily. Under the viscoelastic injection, it’s easier to maintain the correct depth and the anterior chamber. However, the dye must be spread mechanically and can cost more.

Conditions Treated

  • Preparation for eye surgery

Type of medicine

  • Surgical aid

Side effects

Whenever you use any type of medicine, you can experience unwanted side effects. Side effects don’t occur in all patients and not all side effects can be predicted. Be on the lookout for any changes that may require medical treatment.

For trypan blue, contact your health care professional immediately if you notice any of the following before or after your surgery:

  • Unexplained changes to your health
  • Blue color in your eye that doesn’t clear up
  • Discolored artificial lens

If you experience side effects that aren’t on this list, don’t hesitate to call a doctor or nurse to check whether there is cause for concern. In the event of a life-threatening side effect, go to your nearest emergency room or call your doctor immediately for instructions. To report your symptoms to the FDA, call 1-800-FDA-1088.

If some of the trypan blue stays in your eyes a few days after surgery, that’s normal. Your eye and tears could be bluish. When your doctor checks your eyes during the post-op checkup, you can ask any questions that you have. She will make sure the dye dissipates completely over time.

For more serious side effects, or symptoms not listed here, you should get medical help right away.

  • Common side effects that may indicate an allergic reaction include:
  • Rash, itching or hives
  • swollen mouth, lips, tongue or throat
  • Blistered, red or peeling skin (accompanied by a fever or not)
  • trouble breathing, wheezing, tight chest
  • hoarseness or difficulty talking
  • Blurred vision, eye irritation or eye pain

Dosage

A doctor will administer trypan blue during your surgery, so you shouldn’t have to worry about the dosage. If there is extra dye, it should be washed out of your eye once the surgery is over.

Trypan blue is administered via the following dosage type:

  • Solution

Typically, Trypan blue solution is 0.06 percent concentration, consisting of 0.5 mL of trypan blue, which comes in a sterile, single-use glass syringe (2.25 mL), with a rubber plunger stopper and polypropylene plunger rod in a peel pouch.

If you would like to understand how the dosage will be provided during surgery, ask your doctor to walk you through the procedure as part of your preparation for the cataract surgery. You can obtain the labeling and documentation that comes with the dosage and read all the information available.

Trypan blue is only meant for your eyes, in preparation for surgery and should not be taken for any other condition. Make sure you leave your contacts out on the day of the procedure. Once the excess solution is removed, you may be able to put your contact back in, depending on what your doctor recommends.

Even if your doctor gives the go-ahead for you to put your lenses back in, make sure that you don’t put them into your eyes if they are irritated or if there is any sign of infection.

Interactions

Drug Interactions

If you are on any medications or prescriptions, ask your doctor if there is any concern with using them in the days leading up to your surgery. Some medicines should not be prescribed together, but this medication is necessary for your eye surgery. Your doctor may recommend that you avoid or reduce certain prescription medications. Be sure to tell your doctor if you are taking any over-the-counter medication as well as any prescriptions you’re taking.

Other Interactions

Ask your healthcare professional if there are any foods or drinks you should avoid. Sometimes, medication causes unintended interaction with food and beverages. If you are allergic to any food, let your doctor know so he can advise you whether there are any concerns about an allergic reaction with trypan blue.

Using tobacco products or drinking beer, wine and other alcoholic beverages is not advisable when under the influence of prescription drugs or products, such as trypan blue. If you don’t plan to refrain from tobacco or alcohol use, consult a healthcare professional regarding possible side effects.

Warnings

Normally, when you are given a prescription, there is a chance to weigh the pros and cons of taking it, since there are always risks when taking a new drug. In the case of trypan blue, it’s a one-time occurrence that you have to endure to get the benefit of the cataract surgery.

Trypan blue is widely believed to be safe. However, it has been found to be carcinogenic in rats. According to the Mayo Clinic, in one study, rats developed lymphomas after being given subcutaneous injections of one percent trypan blue, However, the rats received the dosage at 50 mg/kg every two weeks for a year. It should be noted that the total dosage in this study was about 1.25 million times the normal dosage administered on a one-time basis before eye surgery.

In a similar study, trypan blue became mutagenic during an Ames test. It caused the breakage of in vitro DNA strands.

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your doctor if you have any allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

There are not enough conclusive studies to determine if there are any specific risks to children associated with the usage of trypan blue. Therefore, there are no results indicating that the use of trypan blue for kids should be limited.

Geriatric

There are not enough conclusive studies to determine if there are any specific risks to the elderly associated with the usage of trypan blue. Therefore, there are no results indicating that the use of trypan blue for senior citizens should be limited.

Storage

Ideally, trypan blue should be stored between 15 and 25 degrees Celsius, and it should be kept out of direct sunlight for the best result. However, you shouldn’t have to worry about storing this drug at home, since it is administered directly by health care professionals before surgery.

Summary

Trypan blue is a dye used as a surgical aid in cataract surgery. It potentially decreases the risk of eye surgery and there is little risk, in general, of severe side effects. This useful drug is only available via prescription and is administered directly by a healthcare professional, making it one of the least stressful drugs to evaluate.

Resources
Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
Content Source: