Phacoemulsification in eyes with white cataract

Abstract

SUMMARY -Phacoemulsification of white cataracts is associated with some difficulties and a higher rate of intraoperative complications. The aim of this report is to describe one of these cases and the possible ways to manage them. We report on cataract surgery in a 79-year-old patient with white mature cataract and insufficient mydriasis because of the pseudoexfoliation syndrome. The use of vital dyes for staining the anterior capsule enhances visualization and helps perform continuous curvilinear capsulorrhexis, which is a key point for performing successful phacoemulsification. In case of small pupils because of insufficient pharmacological mydriasis, we can either enlarge the pupil or work through it. Meticulous preoperative biomicroscopic and A-scan examination (the type of cataract according to intralental A-scan findings) can help select appropriate phaco technique. Despite a higher rate of intraoperative complications, white cataracts can be safely operated on with phacoemulsification technique.

Surgically induced miosis during phacoemulsification in patients with diabetes mellitus

“…The mean duration of phacoemulsification is comparable to that reported in other studies. 31,32 Zaczek and Zetterströ m 20 reported longer duration of phacoemulsification in diabetics compared to healthy controls. The authors attributed their results to the known anatomical changes in the anterior segment of the diabetic eye, the larger diabetic lens which is mainly a result of increased cortical thickening, 6 and possible increased numbers of advanced cataracts in diabetics compared to their age-matched healthy controls.…”

Long-term therapeutic efficacy of phacoemulsification with intraocular lens implantation in patients with phacomorphic glaucoma

“…In addition, the IOL is not in contact with uveal tissues, so pigment dispersion and inflammation are rare. [9][10][11][12] Eyes with phacomorphic glaucoma have very shallow anterior chambers; therefore, we used highly dispersive OVDs to effectively maintain the anterior chambers during manipulation. We used a 26-gauge bent needle to remove the hydrated cortex to minimize dispersion of lens materials and to prevent radial tearing by relaxing the tension on the lens capsule.…”

“…However, there are few reports of the efficacy and surgical outcomes of phacoemulsification in these eyes. [9][10][11][12][13] Thus, we evaluated the long-term therapeutic efficacy of phacoemulsification with IOL implantation in patients with phacomorphic glaucoma.…”

A prospective study on trypan blue capsule staining under air vs under viscoelastic

“…Chakrabarti and Singh 18 retrospectively reported the outcomes of phacoemulsification in eyes with white cataract without the use of dye. As a result of the poor visibility, a complete capsulorhexis could not be achieved in 28.3% of patients.…”