Bradley Truax, MD
SAFETY
3 4
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2 0 1 4
Blue Dye Mix-Up Blinds Patient
OR mistook methylene blue, which is toxic to the eyes, for trypan blue.
O
f the many look-alike, sound-alike drugs in surgery, trypan blue
and methylene blue might be the easiest to confuse. The result
of such a mix-up can blind patients.
•
Trypan blue.
In cataract surgery, trypan blue is used to visualize the
capsulorhexis during phacoemulsification in the absence of a red fundus
reflex.
•
Methylene blue.
Some use this long-lasting tissue-staining dye to mark
the location of the incision.
Methylene blue is, however, highly toxic to the eyes. As these 2
cases illustrate, accidentally injecting methylene blue into the eye
instead of trypan blue can have disastrous consequences.
The cases
Last year in California, a 71-year-old man was undergoing cataract
removal and insertion of an intraocular lens. The surgeon requested
VisionBlue (trypan blue) to stain the lens capsule. The surgical tech
Pamela
Bevelhymer,
RN,
BSN
BLUE DYE MIX-UP It's easy to mix up look-alike, sound-alike drugs such as methylene blue
and trypan blue.
