Preoperative neodymium:YAG anterior capsulotomy in intumescent cataract: Preventing extension of the capsular tear to the lens periphery

Abstract

Extension of the capsulotomy into the periphery is a well-known complication of cataract surgery in young patients with intumescent cataracts. We report such a case successfully treated preoperatively with a neodymium:YAG laser anterior capsulotomy.

Anterior capsulotomy with an ultrashort-pulse laser

“…2 The size, shape, and centration of the capsulorhexis can be variable depending on the type of cataract [3][4][5] as well as the surgeon's experience.…”

Preoperative Nd:YAG laser anterior capsulotomy in white intumescent cataracts: report of 11 cases

“…After emulsification of the nucleus, the small CCC was enlarged to the desired diameter. With this technique, CCC was achieved in 57 eyes (95%) (11) ; but other authors reported a 28.3% incidence of incomplete capsulorhexis (12) , within a very low success rate in white cataracts with a liquefied cortex (68%) compared to those with a solid cortex (13) . CCC can also be performed in a sealed anterior chamber (8) using a 27 or 30 gauge needle mounted on a 2.5 ml syringe filled with BSS.…”

“…Creating a continuous curvilinear capsulorhexis (CCC) in eyes with white intumescent cataracts is a challenge, because of the difficulty to recognize the intumescent cataract and risk of extension of capsular tears to the lens periphery (2)(3) . Several approaches have been described to avoid this complication (4)(5)(6)(7)(8)(9)(10)(11)(12) , including preoperative neodymium:YAG (Nd:YAG) laser capsulotomy (13) . The objective of this study was to describe the use of preoperative Nd:YAG laser anterior capsulotomy for phacoemulsification in eyes with white intumescent cataracts in terms of the intraoperative difficulties and postoperative outcomes.…”

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

“…[2][3][4][5][11][12][13][14][15][16][17][18][19][20][21][22][23] The use of trypan blue, 23 puncture of the anterior capsule with positive pressure in the anterior chamber, and 2-stage capsulorhexis 13 have significantly improved the results of senile white cataract surgery. Despite this, the Argentinean flag sign continues to occur.…”