MINI-rhExIS for whItE INtuMESCENt

PURPOSE: To compare the intraoperative safety of two techniques of capsulorhexis for intumescent white cataracts: traditional one-stage continuous curvilinear capsulorhexis and two-stage continuous curvilinear capsulorhexis. METHODS: This prospective comparative randomized study included two groups: the 1-CCC group (11 patients) received traditional one-stage continuous curvilinear capsulorhexis with 5-6 mm diameter, and the 2-CCC (13 patients) group received a deliberately small continuous curvilinear capsulorhexis that was secondarily enlarged, or a two-stage continuous curvilinear capsulorhexis. Patients were stratified according to cataract subset, which was characterized echographically. Six patients were considered as type 1, fifteen as type 2 and three as type 3. Type 1 included intumescent white cataracts with cortex liquefaction and extensive internal acoustic reflections, type 2 included white cataracts with voluminous nuclei, a small amount of whitish solid cortex, and minimal internal acoustic reflections, and type 3 included white cataracts with fibrous anterior capsules and few internal echo spikes. RESULTS: With the one-stage technique, 46.15 % of patients had leakage of the liquefied cortex; in addition, the surgeon perceived high intracapsular pressure in 61.53 % of cases. Anterior capsule tears occurred in 23.07 % of cases, discontinuity of capsulorhexis in 30.79 % of cases and no posterior capsular rupture occurred. With the two-stage technique, leakage of the liquefied cortex oc-curred in 45.45 % of cases; additionally, the surgeon perceived high intracapsular pressure in 36.36 % of cases. No anterior capsule tears, discontinuity of capsulorhexis or posterior capsular rupture occurred. Considering each cataract subset, there was a highe