We describe a technique to prevent milky liquefied cortical matter from obscuring the view of the anterior chamber and radial tears caused by high intracapsular pressure in eyes with hypermature or intumescent cataract. The continuous curvilinear capsulorhexis (CCC) is created in a sealed anterior chamber without capsule staining or viscoelastic material. Ninety-four consecutive CCCs were performed by a single surgeon over 24 months using the method. A successful CCC was achieved in all eyes. Four cases had complications that occurred late in the surgery and were not related to the CCC.

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Marked cells and flare with angle hypopyon were present in the anterior chamber. A thin-walled bleb existed at the upper side of the conjunctiva. However, no opaque or leakage was seen in the bleb. The fundus was invisible because of extreme vitreous opacity.A pars plana vitrectomy was conducted with a tentative diagnosis of bleb-related endophthalmitis. The retina was mostly intact and several exudative lesions with white vessels were observed at the nasal and inferior mid-peripheries of the fundus (Figure 1). Suspecting of a viral infection, vitreous humour was sampled. Whereas the culture examination resulted in no bacterial growth, varicella-zoster virus (VZV)-specific DNA was detected by polymerase chain reaction (PCR). The patient was diagnosed as ARNS caused by VZV.Intravenous infusion of acyclovir of 750 mg/day and oral corticosteroid of 40 mg/day with topical corticosteroid were initiated. The white-exudative lesions gradually subsided and became necrotic degeneration. Visual acuity improved up to 160/200 in the right eye 2 months after vitrectomy.To our knowledge, this is the first description of ARNS mimicking bleb-related endophthalmitis. We should be aware that viral infection could masquerade clinical features resembling a bacterial endophthalmitis. AcknowledgementsSponsoring organization: None.