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A novel technique to attain continuous curvilinear capsulorhexis to prevent Argentinian flag sign in cases of white cataract

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Session Details

Session Title: Cataract Surgery Equipment/Instrumentation/Surgical Devices

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 17:27

Venue: Room 4.4

First Author: : M.Balyan INDIA

Co Author(s): :    C. Malhotra,   J. Ram   D. Dhingra   V. Singh   A. Jain        

Abstract Details


To present the results of white cataract cases managed by a new surgical technique to attain Continuous Curvilinear Capsulorhexis (CCC) and standard phacoemulsification


Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India


The study included 20 eyes of 20 patients with white cataract who underwent preoperative anterior chamber depth, lens thickness and ultrsonographic A-scan for intralenticular spikes. Patients were stratified into two subsets, depending upon the intraoperative findings: type 1- Intumescent, type 2- Non Intumescent. Capsulorrhexis was performed in a trypan blue stained capsule using microcapsulorrhexis forceps after partial entry into anterior chamber with 2.2 mm keratome and aspiration of fluid cortex using 30 gauge needle of insulin syringe entered through a separate limbal stab incision and tipping the nucleus edge posteriorly so as to release the posterior intralenticular pressure as well. The main port was secondarily enlarged for phacoemulsification. Anterior chamber was maintained throughout the procedure using a high density ophthalmic viscosurgical device.


Based on the intraoperative findings, 11 eyes were categorized as type I-Intumescent cataract and 9 eyes as type 2-Non Intumescent cataract. Argentinian Flag sign was not noted in any of the cases. Successful CCC was achieved in 100% cases with in the Bag Intraocular Lens Implantation. In the Intumescent subtype, surgeon perceived raised intraocular pressure in 81% and cortical leak in 46% of the cases. Overall, posterior capsular plaque was observed in 22% of the cases, leathery cortex in 15%. Elschnig’s pearl type cortex in 10% and anterior capsular plaque in 5% of the cases. At 6weeks follow up 75% patients had best corrected visual acuity of 20/40 or better.


White cataract cases can be safely managed with good results by a newer technique to attain continuous curvilinear capsulorrhexis with the small main port incision and after aspiration of fluid cortex by retropulsing the nucleus edge posteriorly.

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