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Modified two stage capsulorhexis: a novel approach for predictable capsulorhexis outcomes in white turgid cataracts

Poster Details

First Author: R.Chaudhary INDIA

Co Author(s):    S. Chaudhary                    

Abstract Details


Capsulorhexis in white turgid cataract presents a challenge for every young ophthalmologist in training. High Intra Lenticular pressure poses difficulty in controlling the capsulorhexis, and can cause the capsulorhexis to radially tear out or in some cases lead to an argentinian flag sign. We present a technique which can be easily adapted by a beginner surgeon for outmost control in capsulorhexis in white turgid cataract.


Eye7 Hospital


High intra-lenticular pressure superimposed by high external OVD pressure increases the tendency for capsulorhexis to tear out. Under low OVD external pressure, capsulorhexis is started giving a small central nick which is immediately rotated. Loose cortical matter oozing out is washed out with OVD, and a small 2.5 mm capsulorhexis is completed. Hydro-dissection flushes out loose cortex to decompress the bag, Phaco in central opening along with rocking of nucleus decompress the bag further. A secondary nick is taken on CCC and capsulorhexis enlarged to desired size. �Â� 


A small CCC of 2.5 mm has less risk of running out than a 5 mm CCC with an underlying raised intra-lenticular pressure. A complete small rhexis offers a strong rim and prevents a tear during bag decompression. Once the bag is decompressed, the rhexis can be extended to desired size. A smaller rhexis means we can make a wider capsular ribbon of 1.25 mm width, the edge of which can be easily controlled with a capsular forceps. The technique was adopted in total of 100 cases and incidence of rhexis running out with this technique has reduced by 70%.�Â� 


Two-stage �Â� capsulorhexis helps prevent unexpected radial tears and other complications due to high intra-lenticular pressure, thus providing a safe cataract surgery experience for ophthalmologists in white tugid cataracts

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