Safety and efficacy of the novel surgical dye from blue butterfly pea flower: an ex vivo and in vitro study
Keywords:
Anterior lens capsule staining, butterfly pea flower, lens capsular staining dyeAbstract
Background: The chemical dyes were used for anterior capsule staining with caution. There is no natural dye available. The extract from traditional Thai herb may be an alternative dye.
Objectives: To assess the in vitro cytotoxicity of the novel surgical dye on corneal endothelial cells and evaluate the proper concentration for staining on anterior lens capsule during cataract surgery in ex vivo.
Methods: Safety of the dye in various concentrations on human corneal endothelial cell line was evaluated by resazurin technique. The efficacy of human anterior capsular staining at different concentrations of the dye and different time-points was also studied under an operative microscopic camera recorder.
Results: The cytotoxicity test showed no significant viability loss at any concentration. The ex vivo tests on 20 pieces of human anterior capsules were arranged in 5 sets and exposed to 4 different concentrations of the dye at various times. The concentration of 500 - 1,000 mg/ml provided better staining than the 200 mg/ml concentration, while the concentration of 40 mg/ml solution gave a negative stain.
Conclusion: The novel surgical dye from butterfly pea flower extract was successfully developed. The dye solution exhibited non-toxic to corneal endothelial cells and showed suitable for anterior lens capsule staining. Overall, it could be an alternative for safe staining of the anterior lens capsule in cataract surgery.
Downloads
References
Jacob S, Agarwal A, Agarwal A, Agarwal S, Chowdhary S, Chowdhary R, et al. Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract. J Cataract Refract Surg 2002;28:1819-25.
https://doi.org/10.1016/S0886-3350(01)01316-5
Fridman G, Rizzuti AE, Liao J, Rolain M, Deutsch JA, Kaufman SC. Trypan blue as a surgical adjunct in pediatric cataract surgery. J Cataract Refract Surg 2016;42:1774-8.
https://doi.org/10.1016/j.jcrs.2016.10.012
Gillman J, Gilbert C, Gillman T. A preliminary report on hydrocephalus, spina bifida and other congenital anomalies in the rat produced by trypan blue; the significance of these results in the interpretation of congenital malformations following maternal rubella. S Afr Med J 1948;13:47-90.
Ford RJ, Becker FF. The characterization of trypan blue-induced tumors in Wistar rats. Am J Pathol 1982; 106:326-31.
Abdelmotaal H, Abdelazeem K, Hussein MS, Omar AF, Ibrahim W. Safety of trypan blue capsule staining to corneal endothelium in patients with diabetic retinopathy. J Ophthalmol 2019;2019:4018739.
https://doi.org/10.1155/2019/4018739
van Dooren BT, de Waard PW, Poort-van Nouhuys H, Beekhuis WH, Melles GR. Corneal endothelial cell density after trypan blue capsule staining in cataract surgery. J Cataract Refract Surg 2002;28:574-5.
https://doi.org/10.1016/S0886-3350(02)01315-9
Chung CF, Liang CC, Lai JS, Lo ES, Lam DS. Safety of trypan blue 1% and indocyanine green 0.5% in assisting visualization of anterior capsule during phacoemulsification in mature cataract. J Cataract Refract Surg 2005;31:938-42. https://doi.org/10.1016/j.jcrs.2004.12.046
Buzard K, Zhang JR, Thumann G, Stripecke R, Sunalp M. Two cases of toxic anterior segment syndrome from generic trypan blue. J Cataract Refract Surg 2010;36:2195-9.
https://doi.org/10.1016/j.jcrs.2010.09.017
Wilińska J, Mocanu B, Awad D, Gousia D, Hillner C, Brannath W, et al. New stains for anterior capsule surgery. J Cataract Refract Surg 2019;45:213-8. https://doi.org/10.1016/j.jcrs.2018.09.016
Duangkhet M, Chikoti Y, Thepsukhon A, Thapanapongworakul P, Chungopast S, Tajima S, et al. Isolation and characterization of rhizobia from nodules of Clitoria ternatea in Thailand. Plant Biotechnology (Tokyo) 2018;35:123-9. https://doi.org/10.5511/plantbiotechnology.18.0402a
Khoo HE, Azlan A, Tang ST, Lim SM. Anthocyanidins and anthocyanins: colored pigments as food, pharmaceutical ingredients, and the potential health benefits. Food Nutr Res 2017;61:1361779.
https://doi.org/10.1080/16546628.2017.1361779
Bagchi D, Garg A, Krohn RL, Bagchi M, Bagchi DJ, Balmoori J, et al. Protective effects of grape seed proanthocyanidins and selected antioxidants against TPA-induced hepatic and brain lipid peroxidation and DNA fragmentation, and peritoneal macrophage activation in mice. Gen Pharmacol 1998;30:771-6.
https://doi.org/10.1016/S0306-3623(97)00332-7
Sharma N, Singhal D, Maharana PK, Dhiman R, Shekhar H, Titiyal JS, et al. Phacoemulsification with coexisting corneal opacities. J Cataract Refract Surg 2019;45:94-100.
https://doi.org/10.1016/j.jcrs.2018.09.015
Ho WT, Chang JS, Chen TC, Chou SF, Wang IJ, Chang SW. Evaluation of patent blue as the vital dye in an animal model of descemet membrane endothelial keratoplasty. Cornea 2019;38:360-3.
https://doi.org/10.1097/ICO.0000000000001833
Laroche D, Nortey A, Ng C. A novel use of trypan blue during canalicular glaucoma surgery to identify aqueous outflow to episcleral and intrascleral veins. J Glaucoma 2018;27:e158-e61.
https://doi.org/10.1097/IJG.0000000000001030
Grover DS, Fellman RL. Confirming and establishing patency of glaucoma drainage devices using trypan blue. J Glaucoma 2013;22:e1-2. https://doi.org/10.1097/IJG.0b013e318240857c
Parker JS, Parker A, Parker JS. Trypan blue-assisted microinvasive glaucoma surgery. J Cataract Refract Surg 2017;43:1613. 6:2195-9. https://doi.org/10.1016/j.jcrs.2017.10.031
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Chulalongkorn Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
