A Safe and Successful Capsulorhexis Technique for the Intumescent Cataracts; Modified Two-Stage Continuous Curvilinear Capsulorhexis

Gaurav Brahmbhatt, Dr. Jigeesh Desai

Abstract: Background: Intumescent cataracts present unique challenges during capsulorhexis, primarily because abrupt decompression can lead to rapid radial extension of the capsular tear. This study presents a modified two-stage capsulorhexis approach aimed at improving tear control and minimizing intraoperative complications. Materials and methods: A two-step capsulorhexis approach was utilized. Initially, a limited central rhexis of approximately 1.5-2 mm was created to permit controlled release of intralenticular fluid. Milky cortical material was aspirated through a 25-gauge cannula to normalize the pressure gradient between the lens capsule and the anterior chamber. Following adequate decompression, the capsular opening was progressively expanded to a diameter of 5-6 mm to facilitate stable nucleus management and safe phacoemulsification. The study was conducted between May 2024 and October 2024. Results: This case series comprised 40 consecutive eyes with intumescent cataract, including 22 male and 18 female patients. The mean age of the cohort was 66 ± 8 years, with ages ranging from 53 to 84 years. A complete, well-centered continuous curvilinear capsulorhexis of approximately 5-6 mm was successfully obtained in 39 eyes, corresponding to a success rate of 97.5%. One eye exhibited peripheral extension of the capsular tear during the second-stage enlargement. The extension was controlled by trimming the affected capsular edge with Vannas scissors, permitting completion of the procedure without further complication. All eyes underwent successful in-the-bag intraocular lens implantation. Conclusions: This staged approach provides improved control over capsular tear propagation when compared with a conventional single-stage capsulorhexis. Adoption of this technique may enhance intraoperative safety and predictability during phacoemulsification in eyes with intumescent cataract.

Keywords: Capsulorhexis, Intumescent cataract, Phacoemulsification, Cataract surgery, Anterior capsule

How to Cite?: Gaurav Brahmbhatt, Dr. Jigeesh Desai, "A Safe and Successful Capsulorhexis Technique for the Intumescent Cataracts; Modified Two-Stage Continuous Curvilinear Capsulorhexis", Volume 15 Issue 1, January 2026, International Journal of Science and Research (IJSR), Pages: 846-849, https://www.ijsr.net/getabstract.php?paperid=MR26114032445, DOI: https://dx.doi.org/10.21275/MR26114032445