Intraoperative complications in intumescent cataract surgery using a phaco capsulotomy technique

PurposeTo evaluate intraoperative complications of a modified phaco capsulotomy technique and the ophthalmic viscosurgical device (OVD)–assisted capsulorhexis in eyes with intumescent white cataract.SettingLütfi Kırdar Kartal Eye Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey.DesignComparative randomized case study.MethodsEyes 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.ResultsEighty 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.ConclusionThe modified phaco capsulotomy technique might reduce the risk for capsule tear during capsulorhexis, leading to safe cataract surgery in cases of intumescent cataracts.Financial DisclosureNone of the authors has a financial or proprietary interest in any material or method mentioned.