Fluorescein blue, light-assisted capsulorhexis for mature or hypermature cataract

This technique is for use in eyes with mature or hypermature cataract resulting in lack of fundus reflex during capsulorhexis. Fluorescein staining is performed before the capsulorhexis is made. A blue filter in the coaxial light accentuates the remaining rim of bright blue fluorescence and aids in exact formation of the anterior opening. Seven eyes with a postoperative visual acuity of light perception had surgery using this technique. Visual acuity ranged from 20/200 to 20/20 up to 3 months postoperatively. No untoward reaction to the fluorescein was observed; however, the long ultrasound exposure for very hard nuclei (up to 4 minutes) caused corneal edema in two eyes. This technique is regularly used in all eyes with insufficient fundus reflex caused by lens opacity or vitreous disease.