The effects of trypan blue use on the corneal endothelium during cataract surgery in patients with pseudoexfoliation syndrome (PEX).

PURPOSE: In the present clinical study, it was aimed to investigate the possible effects of Trypan blue (TB) use on the corneal endothelium during cataract surgery in eyes with pseudoexfoliation syndrome (PEX) during a three-month follow-up period using the contralateral eye control design. METHODS: This prospective, randomised controlled, individual cohort study included 92 eyes of 46 patients with bilateral PEX and cataracts. While 1% TB was applied to one eye of the patients before capsulorhexis (study group), it was not applied to the other eye (control group). Both groups were compared preoperatively and postoperatively in terms of endothelial cell density (ECD), endothelial cell loss (%), pleomorphism, polymegathism and central corneal thickness (CCT) using specular microscopy. RESULTS: Preoperative corneal ECD was measured as 2362.56 ± 253.27 in the study group, 2380.84 ± 220.54 in the control group, and 2145.58 ± 221.71 in the study group and 2184.97 ± 200.94 cells/mm2 in the control group in the postoperative 3rd-month follow-up (p = 0.71 and = 0.37, respectively). In addition, there were no significant differences between the two groups in terms of the percentage of hexagonal cells, coefficient of variation (CV), and CCT both preoperatively and postoperatively 3 months later (p = 0.78, =0.39, =0.95 preoperatively and p = 0.31, =0.26, =0.83 postoperatively, respectively). CONCLUSION: This study demonstrated that the injection of 1% TB into the anterior chamber for staining the anterior capsule during cataract surgery did not cause significant corneal endothelial changes at postoperative 3rd months, despite the increased fragility of corneal endothelial cells in patients with PEX.

AIR/FLUID-DROPPING TECHNIQUE FOR INTRACAPSULAR DISTILLED WATER APPLICATION: A Vitrectomy Approach for Selective Targeting of Lens Epithelial Cells.

PURPOSE: We describe a simplified technique of intracapsular distilled water application for targeting lens epithelial cells using vitrectomy approach of fluid-air exchange and to evaluate the reliability and safety of this technique. METHODS: Consecutive patients with cataract were randomly assigned to treatment group and control group. After the nucleus removal and cortical aspiration, the space of anterior chamber and capsular bag were maintained with continuous infusion of sterile air by using fluid-air exchange technique through side-port incision. Distilled water was dropped into the capsular bag using a specially designed syringe. A concave air-fluid surface (a physical phenomenon) insured the contact of distilled water with the inner surface of the capsule without overflowing from the bag. The distilled water remained in place for 3 minutes and was then removed by the syringe. RESULTS: No intraoperative surgical complication was observed, and no damage to adjacent intraocular structures was observed during the postoperative follow-up. There was no statistical difference of corneal endothelial cell loss between the treatment group and the control group. Histological study confirmed damage to the lens epithelial cells from anterior capsular specimens treated by the technique. CONCLUSION: The simplified technique using vitrectomy approach is safe and specific for targeting lens epithelial cells without associated complications.

Use of trypan blue to assess lymphatic function following trabeculectomy.

IMPORTANCE: To illustrate the importance of lymphatic drainage in assessing trabeculectomy bleb function using intracameral trypan blue. BACKGROUND: To study the lymphatic drainage of trabeculectomy blebs using trypan blue, correlate with bleb function and classify them accordingly. DESIGN: Prospective cross-sectional study in a tertiary care centre. PARTICIPANTS: Thirteen glaucoma patients post-trabeculectomy were studied. METHODS: Trypan blue was injected into the anterior chamber. MAIN OUTCOME MEASURES: The duration taken for dye to stain a drainage bleb or lymphatics is recorded. The extent of the lymphatic structures were measured in clock hours. Intraocular pressure (IOP) prior to surgery was recorded. RESULTS: Eight post-trabeculectomy subjects with dye stained lymphatic vessels had lower IOP (12.6 mmHg, P = .013) compared to the five with no lymphatic vessel staining (mean IOP 23.6 mmHg). Lymphatic extent was inversely related to IOP (P = .021). CONCLUSIONS AND RELEVANCE: Eyes with lymphatic connections to drainage blebs had lower IOP and reduced requirement for topical medications. The extent of lymphatic connection to drainage blebs is related to lower IOP.

Use of trypan blue as an aqueous tracer dye to investigate hypotony where cyclodialysis cleft is suspected.

IMPORTANCE: A new method to help diagnose suspected cyclodialysis clefts. BACKGROUND: To study the use of trypan blue stained aqueous flow patterns in diagnosing causes of hypotony where cyclodialysis clefts were suspected. DESIGN: A case series in a tertiary care centre. PARTICIPANTS: Ten subjects presenting with persistent hypotony and retinal changes. METHODS: Trypan blue was injected into the anterior chamber. MAIN OUTCOME MEASURES: The pattern of dye flow in the anterior chamber was categorized. Intraocular pressure prior to surgery was recorded. RESULTS: All seven subjects with cyclodialysis clefts had a preferential flow to the cleft region. Two hypotonous subjects post trabeculectomy had rapid (5 seconds) and extensive lymphatic staining (6 o'clock hours extent) without visible bleb formation. CONCLUSIONS AND RELEVANCE: Preferential flow of dye to the limbus is a reliable sign of cyclodialysis cleft and helps localize cleft extent. A new cause of hypotony, "lymphatic overdrain," is identified.

[Rate of visual recovery after macular hole surgery with intraoperative optical coherence tomography and visualization of the internal limiting membrane]. / Tempy vosstanovleniia ostroty zreniia posle khirurgicheskogo lecheniia makuliarnykh razryvov s intraoperatsionnym primeneniem opticheskoi kogerentnoi tomografii i razlichnykh metodov vizualizatsii vnutrennei pogranichnoi membrany.

Currently, multiple techniques exist to repair a macular hole, but the functional result may be largely affected by the use of dyes during surgery. With our original visualization methods, one is able to remove the internal limiting membrane (ILM) without staining, and thus to avoid the toxic effect of dyes. AIM: to compare anatomical and functional results of surgical closure of large macular holes with or without ILM staining. MATERIAL AND METHODS: A total of 160 patients (190 eyes) were divided into 2 groups. Patients from group 1 (60 eyes) were subjected to surgery that involved the use of a dye, while in group 2 (130 eyes) ILM was not performed. Anatomical and functional results of the two groups were then compared. RESULTS: The next day after surgery, a large improvement in the best corrected visual acuity - of 3 lines or more - was found in 28 controls (46.6%) and 98 patients from the main group (75.4%). There was no significant change in 24 and 27 patients, respectively (40.0% and 20.7%). The remaining 8 and 5 patients (13.4% and 3.9%) deteriorated by 3 lines or more. CONCLUSION: Stain-free removal of the ILM under green-yellow light favours rapid recovery of visual acuity in patients with macular holes. Anatomical reconstruction of the foveola, including complete approximation of the hole margins and keeping the defect closed until the end of the operation, is controlled through a built-in optical coherence tomograph ensuring high anatomical and functional results.

Reloadable Silk-Hydrogel Hybrid Scaffolds for Sustained and Targeted Delivery of Molecules.

Tunable repeated drug administration is often inevitable in a number of pathological cases. Reloadable 3D matrices for sustained drug delivery are predicted as a prospective avenue to realize this objective. This study was directed toward sonication-induced fabrication of novel reloadable Bombyx mori silk fibroin (SF) (4, 6, and 8 wt %) hydrogel, injected within 3D porous (8 wt %) scaffolds. The focus was to develop a dual-barrier reloadable depot system for sustained molecular cargo release. Both the varying SF concentration (4, 6, and 8 wt %) and the sonication time (30, 45, and 60 s) dictated the extent of cross-linking, ß-sheet content, and porosity (1-10 µm) influencing the release behavior of model molecules. Release studies of model molecules (trypan blue, TB, 961 Da and bovine serum albumin, BSA, 66 kDa) for 28 days attested that the variations in their molecular weight, the matrix cross-linking density, and the scaffold-hydrogel interactions dictated the release behavior. The Ritger and Peppas equation was further fitted into the release behavior of model molecules from various SF matrices. The hybrid constructs exhibited high compressive strength along with in vitro compatibility using primary porcine chondrocytes and tunable enzymatic degradation as assessed for 28 days. The aptness of the constructs was evinced as a reloadable model molecule (BSA and fluorescein isothiocyanate-inulin, 3.9 kDa) depot system through UV-visible and fluorescence spectroscopic analyses. The novel affordable platform developed using silk scaffold-hydrogel hybrid constructs could serve as a sustained and reloadable drug depot system for administration of multiple and repeated drugs.

The antinociceptive effects of intracerebroventricular administration of Chicago sky blue 6B, a vesicular glutamate transporter inhibitor.

Accumulating evidence suggests that vesicular glutamate transporters (VGLUTs), which control the storage and release of glutamate, may play a role in pain processing. Chicago sky blue 6B (CSB6B), which is structurally related to glutamate, is a competitive VGLUT inhibitor without affecting plasma membrane transporters. The present study was designed to investigate the antinociceptive effects of CSB6B in a number of pain models. The hot-plate test was used as an acute thermal pain test. Inflammatory pain was evaluated using acetic acid writhing, formalin, and complete Freund's adjuvant tests. Intracerebroventricular administration of CSB6B did not affect acute thermal pain responses in 50 or 55°C hot plate tests. However, CSB6B attenuated acetic acid-induced writhing in a dose-dependent and time-dependent manner. In addition, CSB6B reduced licking/biting behavior during the second phase, but not during the first phase, following an intraplantar injection of formalin. In the complete Freund's adjuvant test, a significant attenuation of thermal hyperalgesia was also observed in CSB6B-treated mice. At antinociceptive doses, CSB6B did not affect mice spontaneous locomotor activity. The present study shows that pharmacological inhibition of VGLUT activity was sufficient to attenuate experimental inflammatory pain and suggests that regulation of VGLUTs might be a novel therapeutic strategy for the treatment of pain.

Development of an intrabiliary MR imaging-monitored local agent delivery technique: a feasibility study in pigs.

PURPOSE: To investigate the feasibility of using magnetic resonance (MR) imaging to monitor intrabiliary delivery of motexafin gadolinium (MGd) into pig common bile duct (CBD) walls. MATERIALS AND METHODS: Animal studies were approved by the Institutional Animal Care and Use Committee. Initially, human cholangiocarcinoma cells were treated with various concentrations of MGd, a compound serving as a T1-weighted MR imaging contrast agent, chemotherapy drug, and cell marker. These cells were then examined by means of confocal microscopy to confirm the intracellular uptake of MGd. In addition, an MGd/trypan blue mixture was locally infused into CBD walls of six cadaveric pigs using a microporous balloon catheter. CBDs of six pigs were infused with saline to serve as controls. Ex vivo T1-weighted MR imaging of these CBDs was performed. For in vivo technical validation, the microporous balloon catheter was placed in the CBD by means of a transcholecytic access to deliver MGd/trypan blue into CBD walls of six living pigs. T1-weighted images were obtained with both a surface coil and an intrabiliary MR imaging guidewire, and contrast-to-noise ratios of CBD walls before and after MGd/trypan blue infusions were compared in the two groups by means of paired t test, with subsequent histologic analysis to confirm the penetration and distribution of the MGd/trypan blue agent into CBD walls. RESULTS: In vitro experiments confirmed uptake of MGd by human cholangiocarcinoma cells. The ex vivo experiments demonstrated the penetration of MGd/trypan blue into the CBD walls. The in vivo experiment confirmed the uptake of MGd/trypan blue, showing an increased contrast-to-noise ratio for the CBD after administration of the mixture, compared with images obtained prior to MGd/trypan blue administration (11.6 ± 4.2 [standard deviation] vs 5.7 ± 2.8; P = .04). Histologic results depicted the blue dye stains and red fluorescence of MGd in CBD walls, confirming the imaging findings. CONCLUSION: It is feasible to use MR imaging to monitor the penetration of locally delivered MGd into pig CBD walls.

Practical tip: Chicago Sky Blue (CSB) stain can be added to the routine potassium hydroxide (KOH) wet-mount to provide a color contrast and facilitate the diagnosis of dermatomycoses.

Rapid confirmation of dermatomycoses is desirable because it allows the clinician to initiate appropriate therapy without delay. The routine potassium hydroxide (KOH) wet-mount is cheap and rapid to use but this method lacks a color contrast. We offer a simple practical tip of adding Chicago Sky Blue (CSB) stain to KOH to highlight fungal elements and provide a color contrast that makes reading and interpretation simple, even for the novice.

Characterization of Endothelial Cell Loss in Pre-Descemet Endothelial Keratoplasty Graft Preparation.

PURPOSE: To characterize the pattern and factors affecting endothelial cell loss (ECL) in pre-Descemet Endothelial Keratoplasty (PDEK) graft preparation. METHODS: A prospective study was performed to characterize the pattern of ECL and the impact of inflation pressure in PDEK. Donor corneas were randomized to inflation with air versus Optisol GS storage media. PDEK preparation was performed under continuous pressure monitoring. Trypan blue was used to grade the tissue as acceptable (<25% ECL) or unacceptable (≥25% ECL). Rate of unacceptable ECL was correlated with injection media type and inflation pressure. A retrospective study was then performed of all attempted PDEK preparations at Lions Gift of Sight to evaluate impact of donor tissue factors on ECL. Donor age and tissue preservation time were evaluated and correlated with ECL with PDEK bubbling. RESULTS: Twenty-five corneas were tested prospectively. A reticular pattern of ECL that varied in severity occurred with bubbling. There was no difference in peak inflation pressure or mean expansion pressure between air (706.0, 510.7 mm Hg) and Optisol GS (852.9, 653.0 mm Hg). Increasing peak inflation pressure and mean expansion pressure were associated with an increased risk for unacceptable ECL. On retrospective evaluation of 131 attempted PDEKs, only 44.0% of cases with successful bubbles had acceptable endothelium after processing. Increasing donor age and decreasing preservation time were associated with increased rates of acceptable endothelium. CONCLUSIONS: PDEK processing can result in a reticular pattern of ECL. Higher inflation pressures are associated with greater ECL. Older donor tissues with shorter preservation times might be preferable for PDEK.

Microhandling of vesicular glutamate uptake modulate feeding in broilers.

Glutamate (Glu), the major excitatory neurotransmitter in vertebrate central nervous system, is actively taken up and stored in synaptic vesicles. On the arrival of an action potential to the pre-synaptic membrane and the subsequent opening of the voltage-gated calcium channels and movement of Ca(2+) into the neuron, these small vesicles fuse with the pre-synaptic membrane to release the neurotransmitter content into the synaptic cleft. Because it has previously been shown that intracerebroventricular (ICV) glutamate plays a role in feed intake in broilers, the manipulation of its vesicular concentration could affect feeding behaviour. On the contrary, research on vesicular glutamate transporters has, so far, been carried out on mammalian species. In the present study, we aim to examine the effect of Chicago sky blue 6B (CSB6B), a glutamate vesicular uptake inhibitor, on feed intake and latency to start feeding in a commercial strain of meat type chickens. To do this, four experiments have been designed to investigate the effect of ICV injection of saline, glutamate, as a general agonist for glutamate receptors, CSB6B and the combination of Glu and CSB6B. The findings indicate that CSB6B increases feed intake and decreases the latency to start feeding in 24-h-feed-deprived Ross 208 broilers.

Ab Interno Canaloplasty in Open-angle Glaucoma Patients Combined With In Vivo Trypan Blue Aqueous Venography.

PURPOSE: To demonstrate canalogram patterns observed when trypan blue tracer is combined with oculoviscoelastic device during ab interno canaloplasty, and discuss surgical results and potential implications for diagnosis, prognosis, and treatment. METHODS: This is a retrospective small case series study. RESULTS: The authors performed this procedure on 5 patients with informed consent with 4 to 18 months of follow-up. All procedures have been complication free. The average preoperative intraocular pressure was 16.4 mm Hg with an average number of topical glaucoma medications being equal to 3.6. Postoperatively, the average intraocular pressure for the group was reduced to 13 mm Hg with a concurrent drop in the average number of topical medications used equaling 1.8. CONCLUSIONS: Currently, there are limited practical options to evaluate the patency of the aqueous outflow system in our patients. The primary purpose of this paper is to describe canalogram patterns observed during ab interno canaloplasty with trypan blue. This technique may allow us to further our understanding of the aqueous outflow system and its role in the underlying pathophysiology of glaucoma. Further research is required to evaluate the prognostic and diagnostic significance of this technique.

Role of Vital Dyes in Chromovitrectomy.

ABSTRACT: Chromovitrectomy, the intraocular application of dyes to assist visualization of preretinal tissues during vitreoretinal surgery, was introduced to avoid ocular complications related to internal limiting membrane peeling, inadequate removal of the vitreous, and incomplete removal of epiretinal membranes. Since 2000, chromovitrectomy has become a popular approach among vitreoretinal specialists. The first vital dye used in chromovitrectomy, indocyanine green, facilitated identification of the fine and transparent internal limiting membrane. Following indocyanine green, trypan blue was introduced to identify epiretinal membranes, and triamcinolone acetonide stained the vitreous well. Recently, additional natural dyes such as lutein and anthocyanin from the açaí fruit have been proposed for intraocular application during vitrectomy. The main goal of this review was to study the role of vital stains in chromovitrectomy and report the latest findings in the literature.

Evaluation of mechanical resistance to tearing of the anterior lens capsule after staining with different concentrations of trypan blue.

PURPOSE: To evaluate and compare the mechanical resistance to tearing of the anterior lens capsule opening after staining with different concentrations of trypan blue in ex vivo porcine eyes. SETTING: Semmelweis University, and Budapest University of Technology and Economics, Budapest, Hungary. DESIGN: Experimental study. METHODS: The study comprised 75 porcine eyes. The capsule was unstained in the Control Group (n = 25 eyes), 0.06% trypan blue was used to stain the capsule in Stained 1 Group (n = 25 eyes), and 0.1% trypan blue was used to stain the capsule in Stained 2 Group (n = 25 eyes). After capsulorhexis, the capsule openings were stretched with custom-designed testing equipment until they ruptured. The rupture force (RF), circumference stretching ratio (CSR), and secant modulus at 10 mN (SM10mN) and 50 mN (SM50mN) were evaluated. RESULTS: In total, 75 eyes were enrolled. There were no statistically significant differences in the RF (P = .8924) or CSR (P = .3876) among the groups. There were no statistically significant differences in the SM10mN (P = .8215) or SM50mN (P = .4184) among the groups. CONCLUSIONS: In this porcine eye model, the trypan blue concentrations that are routinely used in cataract surgery had no effect on capsular rim stability.

Comparative effects of commonly used intraocular dyes on the viability of human retina Müller cells.

This study investigated the in vitro effect of various vital dyes in common clinical use on human Müller cell viability, and it compared the toxicity of these dyes using a cell culture model. Müller cells were exposed to a series of concentrations (1 %, 0.5 %, 0.25 %, and 0.125 % or 12.9 mM, 6.45 mM, 3.22 mM and 1.61 mM) of Indocyanine green (ICG) for 2, 24, 48, and 72 h. Similarly, groups of Müller cells were stained with "Heavy" brilliant blue G (HBBG), Trypan blue (TB) (0.15 %, or 1.56 mM), Membrane-blue-dual (MBD), and ICG (0.25 %, or 3.22 mM) or BBG (0.025 %, or 0.3 mM) with glucose (GS) (50 %, 66 % and 75 % or 2.78 M, 3.67 M and 4.17 M) for 30, 60, and 120 s. Cell viability was measured with the Cell Counting Kit-8 (CCK-8) and Lactate Dehydrogenase (LDH) release assays. We found that high stain concentration and long exposure time resulted in increased toxicity to Müller cells. Nevertheless, ICG seemed to be safe at the clinically relevant concentration of 0.25 % (3.22 mM) in the short time of exposure. TB was safer than both HBBG and MBD, especially HBBG. Hypertonic GS as a dilution was not safe for Müller cells, and the negative effect was more obvious in 0.025 % (0.3 mM) BBG than that in 0.25 % (3.22 mM) ICG. This is the first report to observe the cytotoxicity of commonly used stains in clinical on human Müller cells in vitro, and to provide some basis for further studies, including in vivo investigation.

Inadvertent use of water-based ink instead of trypan blue in cataract surgery.

We report a case of iris atrophy and corneal endothelial decompensation following the inadvertent use of water-based ink for capsular staining during cataract surgery. The anterior chamber was thoroughly irrigated with balanced salt solution after the identification of the wrong dye. Phacoemulsification with minimal ultrasound energy and intraocular lens implantation were performed without complications, and the operation was completed. The patient finally developed bullous keratopathy and underwent penetrating keratoplasty 4 months later.

Atrophy of the retinal pigment epithelium following vitrectomy with trypan blue.

PURPOSE: To report a case of possible trypan blue retinotoxicity after macular hole surgery. METHODS: Retrospective review of case notes and follow-up in one patient with unusual appearance of the fundus after macular hole surgery with trypan blue. RESULTS: A 69-year-old female presented to our eye clinic with a complaint of loss of vision over the last 6 months. Examination showed a full-thickness macular hole in the right eye. She underwent right pars plana vitrectomy with internal limiting peel assisted by trypan blue. Surgery was routine with no difficulty during surgical peel of the inner limiting membrane. Two weeks postoperatively, increased pigmentation and atrophy at the level of the retinal pigment epithelium (RPE) was noted temporal to the fovea. The macular hole appeared closed. Fundus fluorescein angiography showed this to be a lesion with characteristics of RPE atrophy. CONCLUSION: In the absence of excessive peroperative surgical trauma to the region of the scar, the retinal changes may be secondary to possible toxicity due to trypan blue stain, light toxicity or a combination of both.

Efficacy and safety of a new selective laser device to create anterior capsulotomies in cataract patients.

PURPOSE: To compare the efficacy and safety of anterior capsulotomy creation with a new selective laser device (CAPSULaser) with those of manual capsulotomies. SETTING: GEMINI Eye Clinic, Zlin, Czech Republic. DESIGN: Prospective case series. METHODS: Patients were placed in cohorts based on age and cataract grade and randomly allocated to have laser capsulotomy or manual continuous curvilinear capsulorhexis (CCC). The anterior capsule was stained with microfiltered trypan blue 0.4%. The anterior capsulotomy was created with the laser device focused on the anterior capsule through a custom patient interface lens. Intraoperative video analysis with the use of an intraocular ruler and postoperative examinations were used to assess safety and efficacy (accuracy of capsulotomy size, circularity, centration). RESULTS: No intraoperative complications occurred in the laser group or the manual group. All capsulotomies in the laser group were free-floating with no tags or tears. The mean capsulotomy diameter was 5.03 mm overall (range 4.8 to 5.2 mm, laser group; 4.4 to 5.8 mm, manual group). In the laser group, all the capsulotomies were within 0.1 mm ± 0.1 (SD) of the target. The circularity accuracy was greater than 99.0% ± 1.0%; the mean centration of the capsulotomy in relation to the intraocular lens (IOL) was 0.1 ± 0.1 mm. All parameters were statistically significant (P < .01). The IOL-capsulotomy overlap was 360 degrees in all laser cases. CONCLUSIONS: Selective laser capsulotomy using a new proprietary trypan blue formulation was safe and effective in cataract surgery. The sizing, circularity, and centration of the laser capsulotomy were more accurate than those of the manual CCC, resulting in consistent 360-degree IOL coverage.

Using intracameral vital dye as a guide for venting incision in acute corneal hydrops.

PURPOSE: To introduce a new surgical technique for the localization of corneal bulla to drain a massive corneal hydrops. METHODS: Four consecutive cases with acute large protruded hydrops were selected. A limbal paracentesis was made via 15° blade. Afterward, trypan blue with a concentration of 0.1% was injected into the anterior chamber. Upon pooling trypan blue in the bulla, the surgeon immediately marked the primary site of stromal staining before further spreading of the dye. Anterior chamber irrigation was then carried out using balanced salt solution, and the excess of trypan blue was washed out. Subsequently, the surgeon made a beveled venting incision to decompress bulla via 15° blade resulting in a stream of dye egressed from the venting incision. At the end of the surgery, 20% diluted SF6 was injected into the anterior chamber. RESULTS: Postoperatively, Descemet's membrane was attached up to the second postoperative day. The corneal edema was resolved up to 3 weeks. Contact lens-corrected visual acuity was improved in all cases. CONCLUSION: Venting incision under the guide of injected trypan blue into the anterior chamber combined with intracameral SF6 injection could be effectively used for a large acute hydrops. This technique could prevent other interventions like passing full-thickness corneal suturing and subsequent complications.

Banded technique for pediatric traumatic cataract surgery.

We describe a technique for pediatric traumatic cataract management in cases in which part of the anterior capsule has been ruptured. The technique requires creating a 2-incision push-pull capsulorhexis in the intact anterior capsule. The capsulorhexis is made in a manner that converts the edge of the ruptured anterior capsule into a band of capsule that holds the intraocular lens (IOL) in the bag, reducing the incidence of early, intermediate, or late postoperative lens-iris capture. It also reduces the chances of IOL displacement.