title: Indocyanine green-assisted phacoemulsification in cases of complicated or simple advanced cataracts.
abstract: OBJECTIVE
  During phacoemulsification for advanced cataracts, particularly when complicated by anterior segment abnormalities, capsulorhexis is very difficult and carries a high risk of complications. This study investigated the efficacy and safety of indocyanine green (ICG)-assisted phacoemulsification in complicated or simple advanced cataracts.
  
  
  METHODS
  Thirty-two patients (35 eyes) underwent phacoemulsification for complicated advanced cataracts (group 1) or simple advanced (mature/hypermature) cataracts (group 2). Anterior segment abnormalities (corneal opacity, small pupil, or glaucoma) in group 1 complicated phacoemulsification. In both groups, 0.5% ICG was used for capsulorhexis, and subsequent procedures were performed in the same routine manner.
  
  
  RESULTS
  Group 1 included 15 patients (17 eyes) with a mean age of 60.0 years. Group 2 included 17 patients (18 eyes) with a mean age of 69.4 years (p<0.05). Continuous curvilinear capsulorhexis was completed in all eyes in group 2, but radial tears occurred in four (23.5%) eyes in group 1 (p<0.05). Phacoemulsification was performed uneventfully in all eyes in both groups. Postoperative complications (corneal edema, vitreous prolapse, posterior capsule opacity, elevated intraocular pressure) were seen in five (27.8%) eyes in group 1 and four (23.5%) eyes in group 2 (p>0.05). None of these were attributed to the use of ICG. Visual acuity improved in all eyes in group 2, but in only 11 (64.7%) in group 1 (p<0.01).
  
  
  CONCLUSIONS
  ICG-assisted phacoemulsification is safe and helpful for complicated or simple advanced cataracts. Differences between the two groups in patient age, intraoperative complications, and visual outcome could be explained by differences in the cause(s) of advanced cataracts.
authors.affiliation: Department of Ophthalmology and Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Chang
authors.forename: Jing-Hsing
authors.initials: JH
authors.lastname: Hsiao
authors.forename: Sung-Huei
authors.initials: SH
authors.lastname: Tseng
authors.forename: Po-Hsiu
authors.initials: PH
authors.lastname: Kuo
authors.forename: Fred Kuanfu
authors.initials: FK
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D007208:Indocyanine Green