Reply to Letter to the Editor Re: “unintentional Staining of the Anterior Vitreous with Trypan Blue During Cataract Surgery”

Dear Editor, We thank the authors for their contribution to our study. Unfortunately, we did not have chance to look for toxicity using electrophysiological tests, which might be more sensitive to detect subtle changes in function before morphologically observable derangements. It is probable that a small portion of the trypan dye injected into the anterior chamber reached the anterior vitreous cavity and theoretically was later diluted in about 4.5 cc of vitreous cavity fluid. Although vitrectomy was not performed, on clinical examination this dye disappeared quickly postoperatively. The cases were not routine cataract cases, so we attributed the acuity loss either to primary coexistent disease or difficulty in surgery. We did not encounter significant retinal changes in fundus examinations and optical coherence tomography postoperatively; however, we cannot completely rule out toxic effects of trypan blue on the retinal cells without electrophysiological tests. This may be a possible cause of the moderate visual acuity levels reached by the patients, as the contributors justifiably mentioned. Peer-review: Internally peer reviewed.