Intraoperative complications in intumescent cataract surgery using a phaco capsulotomy technique

Abstract

Purpose: To evaluate intraoperative complications of a modified phaco capsulotomy technique and the ophthalmic viscosurgical device (OVD)-assisted capsulorhexis in eyes with intumescent white cataract.

Setting: Lütfi Kırdar Kartal Eye Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey.

Design: Comparative randomized case study.

Methods: Eyes of patients with intumescent white cataract were divided into 2 equal groups. After the anterior capsule was stained with trypan blue, Group 1 received a modified phaco capsulotomy technique and Group 2 received a high-viscosity OVD-assisted capsulorhexis. The OVD used was sodium hyaluronate 2.0% (Protectalon 2.0%) Main outcomes were the capsulorhexis diameters, the deviations from the target diameter, and intraoperative complications.

Results: Eighty eyes of 80 patients were enrolled. There was a deviation from the target capsulorhexis diameter in 15 eyes (11 oversized, 4 undersized) in Group 1 and in 20 eyes (16 oversized, 6 undersized) in Group 2. Capsule tears during capsulorhexis were observed in 2 eyes in Group 1, and the surgery was changed to extracapsular cataract extraction (ECCE) in 1 eye. In Group 2, capsule tears during capsulorhexis occurred in 22 eyes and 20 of these were managed with ECCE.

Conclusion: The modified phaco capsulotomy technique might reduce the risk for capsule tear during capsulorhexis, leading to safe cataract surgery in cases of intumescent cataracts.

Financial disclosure: None of the authors has a financial or proprietary interest in any material or method mentioned.