Needle capsulorhexis in intumescent white cataract using slow injecting viscoelastic device through an anterior chamber maintainer.

The anterior capsulorhexis has got several intra and postoperative advantages over can opener or endocapsular capsulotomies and has become the standard capsulotomy technique for phacoemulsification (Zamini et al 2003, Neuhan TF 2004, Gimbel et al 1990). Anterior capsulorhexis can be performed using 26 G bent needle cystitome or Utratas forceps (Zamini et al 2003, Neuhan TF 2004). The needle capsulorhexis can be performed through side port incision using a viscoelastic device or with irrigating hand piece of bimanual automated irrigation aspiration system. During the performance of capsulorhexis, the globe can be stabilized either using a second instrument such as a Sinskey hook, or by holding limbal conjunctiva with a Lim’s forceps. Sinskey hook introduced through a separate side port incision can lead to egress of viscoelastic device from the eye and hence risk of radial extension of capsular flap. The prerequisites for a good capsulorhexis include a deep well maintained anterior chamber, globe stabilization and properly stained anterior capsule with dye in mature cataract. All these can be achieved by the technique described by us, which is a modification of anterior capsulorhexis under anterior chamber maintainer described previously by Blumenthal et al (1990).