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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,...

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Autores principales: Balyan, Monika, Jain, Arun Kumar, Malhotra, Chintan, Ram, Jagat, Dhingra, Deepika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302304/
https://www.ncbi.nlm.nih.gov/pubmed/34011708
http://dx.doi.org/10.4103/ijo.IJO_1903_20
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author Balyan, Monika
Jain, Arun Kumar
Malhotra, Chintan
Ram, Jagat
Dhingra, Deepika
author_facet Balyan, Monika
Jain, Arun Kumar
Malhotra, Chintan
Ram, Jagat
Dhingra, Deepika
author_sort Balyan, Monika
collection PubMed
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.
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spelling pubmed-83023042021-08-02 Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge Balyan, Monika Jain, Arun Kumar Malhotra, Chintan Ram, Jagat Dhingra, Deepika Indian J Ophthalmol Original Article 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. Wolters Kluwer - Medknow 2021-06 2021-05-21 /pmc/articles/PMC8302304/ /pubmed/34011708 http://dx.doi.org/10.4103/ijo.IJO_1903_20 Text en Copyright: © 2021 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Balyan, Monika
Jain, Arun Kumar
Malhotra, Chintan
Ram, Jagat
Dhingra, Deepika
Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302304/
https://www.ncbi.nlm.nih.gov/pubmed/34011708
http://dx.doi.org/10.4103/ijo.IJO_1903_20
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