PubMed · 10604682
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L S Braude, D P Edward. 1999. Pseudocapsulorrhexis.. https://pubmed.ncbi.nlm.nih.gov/10604682/
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In this technique for managing posterior polar cataract, extreme care is taken not to overpressurize the anterior chamber or capsular bag to prevent posterior capsule rupture. Minimal hydrodissection and hydrodelineation are performed. The nucleus is extracted using minimal ultrasound energy. Viscodissection is used as a primary technique to mobilize the epinucleus and cortex. A protective layer is preserved over the posterior polar region until the conclusion of the extraction procedure to minimize the risk of loss of lens material into the vitreous cavity in the case of a capsule defect.
PURPOSE: To describe an effective surgical technique to visualize an obscured leading edge of a capsulorhexis. DESIGN: Prospective, interventional case series. METHODS: In six eyes of six patients in which the capsulorhexis was started but could no longer be seen during surgery, the anterior chamber was irrigated to remove all viscoelastic, and 0.3-ml trypan blue 0.06% was applied onto the anterior lens capsule to stain and visualize the leading edge of the capsulorhexis. RESULTS: In all patients, the leading edge of the capsulorhexis was quickly visualized by using the dye. No adverse reactions were observed up to 1 year after surgery. CONCLUSION: Trypan blue staining of the anterior lens capsule is an effective and apparently safe technique to "find" a "lost" capsulorhexis during surgery.
Pediatric capsulorhexis is a challenging surgical technique because of the elasticity of the pediatric anterior capsule. This technique of manual capsulorhexis allows reliable and reproducible results for the size and centration of anterior and posterior capsulorhexes in pediatric cases. The technique is a modification of a previously reported method.