To evaluate the safety and efficacy of a modified anterior capsulorhexis technique using an 18-gauge needle puncture at the peripheral one-third of the anterior capsule to control intralenticular pressure and achieve single-stage continuous curvilinear capsulorhexis (CCC) in intumescent cataract surgery. This prospective, cross-sectional descriptive study included patients with intumescent cataracts indicated for surgery at Saigon Vinh Eye Hospital from August 2024 to March 2025. Before CCC, all patients underwent an 18-gauge needle puncture at the peripheral one-third of the anterior capsule near the main incision. A total of 99 eyes from 99 patients were included in the study. The mean axial length was 23.12 ± 0.55 mm, anterior chamber depth 2.62 ± 0.43 mm, and lens thickness 4.91 ± 0.72 mm. In 65 patients (65.7%), the milky liquefied cortex escaped into the anterior chamber after the needle puncture. Single-stage CCC was successfully performed in 98 of 99 cases (98.9%) with a mean capsulorhexis diameter of 5.5 ± 0.3 mm. All surgeries were performed using standard phacoemulsification and in-the-bag IOL implantation (100%). Three months post-operatively, all patients had well-centered IOLs with a best-corrected visual acuity (BCVA) ≥ 4/10. An 18-gauge needle puncture at the peripheral one-third of the anterior capsule offers effective decompression, improves safety, and facilitates CCC in patients with intumescent cataracts. This technique is simple, feasible, and highly applicable in clinical practice.
Hoang et al. (Mon,) studied this question.