Lens decompression technique for prevention of intraoperative complications during phacoemulsification of intumescent cataract

PURPOSE: To evaluate intraoperative complications during phacoemulsification of intumescent cataract using lens decompression technique. METHODS: Participants with intumescent cataract scheduled for phacoemulsification were recruited and divided into two groups. In both groups, after the anterior capsule was stained with trypan blue, the anterior chamber was filled peripherally with a dispersive ophthalmic viscosurgical device (OVD) followed centrally by a higher viscosity cohesive OVD (Healon GV). In Group 2, a 25-gauge needle was then inserted into the lens center and liquid cortex aspirated by pulling back on the syringe plunger. The outcomes measured were the incidence of capsular radial tears and the incidence of conversion to extracapsular cataract extraction (ECCE). RESULTS: In Group 1 (20 eyes), capsular radial tears occurred in four eyes, and in two eyes, the procedure had to be converted to ECCE. In Group 2 (20 eyes), no capsular radial tears or conversion to ECCE was reported. CONCLUSION: Lens decompression technique reduced the risk of capsular radial tears and conversion to ECCE during phacoemulsification of intumescent cataract.