“Swollen” lens: phacoemulsification of white intumescent cataract

Session Details

Session Title: Cataract Surgery Special Cases I

Session Date/Time: Sunday 14/09/2014 | 14:30-16:30

Paper Time: 15:38

Venue: Boulevard G

First Author: : V.Dzinic SERBIA

Co Author(s): :    M. Dzinic              

Abstract Details

Purpose:

to show the surgical technique of phacoemulsification in the series of patients with white – intumescent cataract.

Setting:

Clinical center of Vojvodine, Novi Sad Eye center Dzinic, Novi Sad

Methods:

in 22 patients (22 eyes) cataract surgery was performed. Mean age was 61±19 years, 12 female and 10 male, and visual acuity of light perception (L+P+) in all cases. In all patients coaxial 2.75mm phacoemulsification technique was performed with temporal approach. After trypan blue capsule dying, viscoelastic was introduced in anterior chamber. Initial punch of anterior capsule and aspiration of lens cortical materials were performed in order to lower the pressure within the lens. Then capsulorexis and gentle hydro dissection was performed. Phacoemulsification was performed with B&L Millennium using pulse mode /35% to 45% US, 50 PPS, duty cycle 50%/ using phaco chop technique. The phaco tip was introduced in the middle of the lens, slightly elevated with high vacuum and chopped into small pieces. Aspiration of cortical materials and in the bag implantation of hydrophilic lens was performed in all cases. Follow up periods was 24 months.

Results:

In all patients successful cataract removal was achieved. No posterior capsule rupture was observed. In all patients corneal edema was completely resolved at the follow up visit on the 7th day after the surgery. Best corrected visual acuity in all patients ranges from 0.7 to 1.0 and corneas remain stable and clear during follow up period.

Conclusions:

swollen lens materials in patients with intumescent cataract usually raises the pressure inside the lens. In those circumstances tearing of anterior capsule and “argentian flag” sign can occur easily. It can be quite difficult to perform capsulorhexis since the control of the capsule flap is impaired. This study shows that aspiration of cortical materials, before performing capsulorexis, lowers the tension and provides much better control of capsulorhexis. Slight elevation of the lens and phaco-chop at the level of iris plane lower the stress on capsular bag and zonules and prevents posterior capsule rupture.

Financial Interest:

NONE