Assessment of intraoperative complications in intumescent cataract surgery using 2 ophthalmic viscosurgical devices and trypan blue staining

PURPOSE: To evaluate intraoperative complications during capsulorhexis and phacoemulsification in intumescent white cataracts using 2 ophthalmic viscosurgical device (OVD) techniques. SETTING: Ruhr University Eye Clinic, Bochum, Germany. DESIGN: Case series. METHODS: Patients with eyes with intumescent white cataract were recruited and placed in 2 groups. After capsule staining using trypan blue, a central indentation of the anterior lens capsule was created in the eyes in Group 1 using a medium-viscosity OVD (Healon 1.0%) and in the eyes in Group 2 using both medium-viscosity (1.0%) and high-viscosity (2.3%) OVDs. Then a continuous curvilinear capsulorhexis (CCC) was performed. The outcomes measured were the horizontal and vertical diameters of the CCC, the deviation from the target diameter, and intraoperative complications. RESULTS: In Group 1 (21 eyes), deviation from the target CCC diameter occurred in 12 eyes (10 oversized, 2 undersized), and in Group 2 (20 eyes) deviation occurred in 6 eyes (4 oversized, 2 undersized). In Group 1, capsule tears appeared in 2 eyes and in 1 eye, the procedure had to be converted to extracapsular cataract extraction with anterior vitrectomy. In Group 2, there were no capsule tears. CONCLUSION: Using 2 different OVDs and placing the high-viscosity OVD centrally led to safe indentation of the anterior lens capsule and reduced the risk for CCC enlargement and capsule tear during surgery. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.