The article by Torikai and colleagues reports 6 cases of postoperative Sarocladium kiliense–associated endophthalmitis after cataract surgery that were traced back to a contaminated trypan blue solution. In the US, trypan blue is commercially available as a US Food and Drug Administration (FDA)–approved intraocular dye (VisionBlue, 0.06% [DORC Global]). However, in Japan, this preparation is not readily available, and surgeons must rely on trypan blue formulations that are compounded from research-use reagents when the surgeon elects to stain the capsule. The series of patients described by Torikai and colleagues is commendable in linking the cases to a common source, as is the authors’ management and intervention, which resulted in favorable visual outcomes in these patients. These cases underscore both the vulnerability introduced using off-label compounded or repurposed products as well as the value of epidemiologic monitoring.
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