Three-step technique for staining the anterior lens capsule with indocyanine green or trypan blue

A 3-step technique for staining the anterior lens capsule was developed to optimize the use of a capsule dye (trypan blue or indocyanine green) during capsulorhexis. After the injection of a viscoadaptive ophthalmic viscosurgical device (OVD) (sodium hyaluronate 2.3% [Healon 5]), which fills the anterior chamber, balanced salt solution (BSS) is gently injected onto the anterior capsule, creating a wafer-thin, fluid-filled space beneath the OVD. The dye is slowly injected through a 27-gauge cannula (Duckworth & Kent), selectively mixing with the BSS and allowing relatively accurate painting of the anterior capsule, approximating the size and shape of the intended capsulorhexis. This 3-step technique avoids the use of air as well as the uncontrolled dispersion and excessive accumulation of dye within the OVD.