PubMed · 12160830
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Tanuj Dada, Harinder Sethi. 2002. Forceps capsulorhexis.. https://doi.org/10.1016/s0886-3350(02)01478-5
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We describe a technique to prevent milky liquefied cortical matter from obscuring the view of the anterior chamber and radial tears caused by high intracapsular pressure in eyes with hypermature or intumescent cataract. The continuous curvilinear capsulorhexis (CCC) is created in a sealed anterior chamber without capsule staining or viscoelastic material. Ninety-four consecutive CCCs were performed by a single surgeon over 24 months using the method. A successful CCC was achieved in all eyes. Four cases had complications that occurred late in the surgery and were not related to the CCC.
We describe a technique of capsule staining called capsule painting. Using a Khokhar capsule painting cannula, the dye is spread directly over the anterior capsule but to no other part of the anterior chamber. There is minimal turbulence in the anterior chamber as there is no need to replace the injected viscoelastic material. The use of minimal dye and viscoelastic material reduces the cost of surgery.
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.