Capsulorhexis in intumescent cataract

Abstract

This technique of anterior capsulorhexis is for use in eyes with high intralenticular pressure and absence of red reflex as encountered in intumescent cataract. The initial steps of fashioning the anterior capsular flap and lens decompression are done under the microscope's high magnification and noncoaxial oblique illumination. Intralenticular pressure is controlled by filling the anterior chamber with a viscoelastic agent. Once the lens is decompressed, the capsulorhexis is completed with a capsule forceps and an endoilluminator is used as an oblique source of illumination. This technique allows controlled capsulorhexis in eyes with intumescent cataract.

Chandelier retroillumination-assisted cataract surgery during vitrectomy

“…5,6,[8][9][10] The endoilluminator-assisted technique was first used for capsulorhexis in a patient with intumescent cataract. 11 Yamamoto et al described the trypan blue and endoilumination-assisted phacoemulsification technique in eyes with vitreous hemorrhage. In this two step surgery, after staining the lens capsule with trypan blue, circular capsulorhexis was performed.…”

Surgeon-controlled–endoillumination-guided irrigation and aspiration during combined 23-gauge sutureless vitrectomy and cataract surgery in eyes with poor fundus reflex

“…2,3 To overcome the challenge, anterior capsule staining with indocyanine green or trypan blue and anterior capsule illumination with a light pipe have been used for capsulorhexis. 6,7 Endoillumination-assisted surgery was also introduced in eyes with a compromised red reflex due to severe vitreous opacities or hemorrhages. 2,3 Compared with external microscope illumination, intravitreal illumination has been shown to improve both contrast and resolution.…”

Brazilian technique for prevention of the Argentinean flag sign in white cataract

“…A change in the ionic pump and in the metabolic barrier can lead to the entry of fluid into the lens, increasing, as a result, the intralenticular pressure. 30,31 Regardless of how this process occurs, the senile white cataract presents 3 developmental stages and being acquainted with them will help the phacoemulsification surgeon prevent intraoperative complications.…”