Sewing Needle Microcapsulotomy New Technique To Avert Argentinian Flag Sign In Intumescent Pearly White Cataract

To describe an efficient new technique “Sewing Needle Micro Capsulotomy” to prevent Argentinian flag sign during capsulorrhexis in patients with intumescent pearly white mature cataracts

It is a prospective interventional study done over a period of 6 months.120 eyes with white intumescent cataract were included in this study.

 A sewing needle hook is designed with round pointed apex tip. Simply pricking the centre of the white cataract with the pointed round tip create a round hole which doesn't extend peripherally. Central hole helps to evacuate intralenticular fluid and decompress the capsule. All the patients underwent detailed examination. Exclusion criteria were history of coexisting ocular diseases like uncontrolled glaucoma, ocular tumors, ocular trauma, pseudoexfoliation syndrome, zonular dialysis, poorly dilating pupil.

The capsule is stained with 0.06% trypan blue and the anterior chamber completely filled with OVD. Using the main corneal incision, sewing needle hook inserted into anterior chamber and pointed round tip impaled into the capsule and a round hole is created from which intralenticular fluid is evacuated to decrease the intralenticular pressure. Once the fluid is evacuated capsulorrhexis was completed with Utrata forceps. The sewing needle prick prevented Argentinian flag sign in 98.7% eyes out of 120 eyes. Capsulorhexis was completed in 98% of cases.This technique not only ensures the initial decompression, but also prevents a catastrophic Argentinian flag sign.

An intumescent lens puts the surgeon at risk for Argentinian Flag Sign during capsulorhexis. Simultaneous puncture of the anterior capsule with sewing needle hook decompresses the bag preventing an uncontrolled radial extension of tear. In conclusion, sewing needle hook is a successful and reproducible method of achieving a well-sized CCC.