Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge
Purpose: To present a case series of intumescent white cataract cases managed by a new surgical technique to attain a single stage Continuous Curvilinear Capsulorhexis (CCC). Methods: The series included 60 eyes of 60 patients with white cataract which underwent preoperative anterior chamber depth,...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=6;spage=1398;epage=1403;aulast=Balyan |
| _version_ | 1818461231117238272 |
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| author | Monika Balyan Arun Kumar Jain Chintan Malhotra Jagat Ram Deepika Dhingra |
| author_facet | Monika Balyan Arun Kumar Jain Chintan Malhotra Jagat Ram Deepika Dhingra |
| author_sort | Monika Balyan |
| collection | DOAJ |
| description | Purpose: To present a case series of intumescent white cataract cases managed by a new surgical technique to attain a single stage Continuous Curvilinear Capsulorhexis (CCC). Methods: The series included 60 eyes of 60 patients with white cataract which underwent preoperative anterior chamber depth, lens thickness and ultrasonographic A-scan for intralenticular spikes. A partial size main port (~1.8mm) is created as the first entry into the anterior chamber (AC). A 30-gauge needle of insulin syringe entered through a limbal stab incision is used to decompress the anterior and posterior intralenticular compartments. Following which a standard size, one stage capsulorhexis was performed in a trypan blue stained capsule using microcapsulorhexis forceps entered through the partial sized trapezoidal main port. The main port was secondarily enlarged for phacoemulsification. Results: Based on the intraoperative findings, 43 eyes were categorized as Intumescent type-1 cataracts i.e., with presence of actual liquefied cortex aspirated using 30-gauge needle and 17 eyes as Intumescent type-2 cataracts, i.e., presence of swollen lens without any obvious liquefied cortex. Standard size, circular and centred CCC was achieved in 100% of the cases and no Argentinean flag sign was noted. Surgeon perceived raised intralenticular pressure in 41% of the cases in type-1 subset and 61% cases in type-2 subset (P-0.06). Posterior capsular plaque was observed in 22% of the cases, adherent cortex in 25% and anterior capsular plaque in 5% of the cases. At 6weeks follow up 92% patients had best corrected visual acuity of 20/40 or better. Conclusion: A multi-layered approach can help in attaining successful CCC in cases of white mature cataract with high intralenticular pressure. |
| first_indexed | 2024-12-14T23:42:51Z |
| format | Article |
| id | doaj.art-89a1c374e0854e28be9b376b750202ee |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-12-14T23:42:51Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-89a1c374e0854e28be9b376b750202ee2022-12-21T22:43:29ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892021-01-016961398140310.4103/ijo.IJO_1903_20Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challengeMonika BalyanArun Kumar JainChintan MalhotraJagat RamDeepika DhingraPurpose: To present a case series of intumescent white cataract cases managed by a new surgical technique to attain a single stage Continuous Curvilinear Capsulorhexis (CCC). Methods: The series included 60 eyes of 60 patients with white cataract which underwent preoperative anterior chamber depth, lens thickness and ultrasonographic A-scan for intralenticular spikes. A partial size main port (~1.8mm) is created as the first entry into the anterior chamber (AC). A 30-gauge needle of insulin syringe entered through a limbal stab incision is used to decompress the anterior and posterior intralenticular compartments. Following which a standard size, one stage capsulorhexis was performed in a trypan blue stained capsule using microcapsulorhexis forceps entered through the partial sized trapezoidal main port. The main port was secondarily enlarged for phacoemulsification. Results: Based on the intraoperative findings, 43 eyes were categorized as Intumescent type-1 cataracts i.e., with presence of actual liquefied cortex aspirated using 30-gauge needle and 17 eyes as Intumescent type-2 cataracts, i.e., presence of swollen lens without any obvious liquefied cortex. Standard size, circular and centred CCC was achieved in 100% of the cases and no Argentinean flag sign was noted. Surgeon perceived raised intralenticular pressure in 41% of the cases in type-1 subset and 61% cases in type-2 subset (P-0.06). Posterior capsular plaque was observed in 22% of the cases, adherent cortex in 25% and anterior capsular plaque in 5% of the cases. At 6weeks follow up 92% patients had best corrected visual acuity of 20/40 or better. Conclusion: A multi-layered approach can help in attaining successful CCC in cases of white mature cataract with high intralenticular pressure.http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=6;spage=1398;epage=1403;aulast=Balyancontinous curvilinear capsulorhexisintralenticular pressureintumescent cataract |
| spellingShingle | Monika Balyan Arun Kumar Jain Chintan Malhotra Jagat Ram Deepika Dhingra Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge Indian Journal of Ophthalmology continous curvilinear capsulorhexis intralenticular pressure intumescent cataract |
| title | Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge |
| title_full | Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge |
| title_fullStr | Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge |
| title_full_unstemmed | Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge |
| title_short | Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge |
| title_sort | achieving successful capsulorhexis in intumescent white mature cataracts to prevent argentinian flag sign a new multifaceted approach to meet the challenge |
| topic | continous curvilinear capsulorhexis intralenticular pressure intumescent cataract |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=6;spage=1398;epage=1403;aulast=Balyan |
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