The dye was used for all white mature cataracts which lacked red fundus reflex. A central initial puncture of the anterior capsule was made with a 26 gauge needle, and the needle was moved to the left approximately 2. Above, a slit-lamp view showing bluish hue, b even without a microscope there is a blue tint to the white cataracts, c another bluish white cataract, d trypan blue dye used to stain the capsule, but look within the capsular opening and note the blue hue (not from dye). The bluish hue in a white cataract is due to liquified lens cortex, which makes this an intumescent white cataract. comparison of icg and trypan blue for capsular staining in white cataracts. Download citation anterior capsular staining with trypan blue for capsulorhexis in mature and hypermature cataracts. Most of these cases require anterior capsule staining because they involve mature cataracts. Simply put, i could not operate efficiently in mature cataracts without trypan blue vital dye. Even in more routine cases, staining the anterior capsule with visionblue capsular dye (trypan blue ophthalmic solution 0. 06 dorc international) during cataract surgery is often necessary for better. Surgeons who have resorted to using off-label dyes to stain the anterior lens capsule during cataract surgery have a new ophthalmic solution designed to facilitate removal of very mature cataracts. Capsule staining and mature cataracts a comparison of indocyanine green and trypan blue dyes david f chang. The capsulorhexis for a dense white cataract is shown in the first segment of the video, where capsule visualisation is limited by the poor red reflex and by the release of milky cortical material. Brunescent cataracts may also have surgical implications, as complication rates for mature, brunescent cataracts, such as posterior capsular tear, are higher compared to other cataracts. Dense cataracts often require longer surgery times, which may compromise the corneal endothelium and result in significant post-operative inflammation.