title: Corticocapsular adhesions and their effect during cataract surgery.
abstract: OBJECTIVE
  To identify the types of corticocapsular adhesions by their preoperative clinical appearance and evaluate the difficulties they pose during cataract surgery.
  
  
  METHODS
  Iladevi Cataract & IOL Research Center, Ahmedabad, India.
  
  
  METHODS
  Seventy-six eyes with age-related senile cataract scheduled for phacoemulsification were identified as having corticocapsular adhesions. Preoperatively, the eyes were assessed at the slitlamp to determine the type of corticocapsular adhesions present. During surgery, the surgeon graded nucleus rotation after single-site cortical-cleaving hydrodissection as easy, difficult, or not possible. Additional multiquadrant-focal hydrodissection was performed. The surgeon's impressions of the presence of corticocapsular adhesions and visualization of the furry surface of the epinucleus were noted.
  
  
  RESULTS
  Corticocapsular adhesions were confirmed in 86.84% of eyes. Equatorial corticocapsular adhesions alone or in combination were present in 72 eyes (94.74%) eyes, anterior corticocapsular adhesions in 40 (52.74%), and posterior corticocapsular adhesions in 42 (56.26%). Rotation of nucleus was not possible in 47.37% eyes, difficult in 39.47%, and easy in 13.16%.
  
  
  CONCLUSIONS
  The surgeon should perform a thorough preoperative slitlamp evaluation in extreme gaze with a fully dilated pupil. Equatorial corticocapsular adhesions, which were present in most eyes, made nucleus rotation difficult. Additional multiquadrant and focal cortical-cleaving hydrodissection helped separate the adhesions and achieve successful rotation.
authors.affiliation: Iladevi Cataract & IOL Research Centre, Ahmedabad, India. shail@ad1.vsnl.net.in
authors.forename: Abhay R
authors.initials: AR
authors.lastname: Vasavada
authors.forename: Deepa
authors.initials: D
authors.lastname: Goyal
authors.forename: Lajja
authors.initials: L
authors.lastname: Shastri
authors.forename: Raminder
authors.initials: R
authors.lastname: Singh
mesh_terms: D002386:Cataract / Q000175:diagnosis*; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D007904:Lens Cortex, Crystalline / Q000473:pathology* / Q000601:surgery; D018918:Phacoemulsification; D010865:Pilot Projects; D011446:Prospective Studies; D000267:Tissue Adhesions