title: Intraoperative complications in intumescent cataract surgery using a phaco capsulotomy technique.
abstract: To evaluate intraoperative complications of a modified phaco capsulotomy technique and the ophthalmic viscosurgical device (OVD)-assisted capsulorhexis in eyes with intumescent white cataract.
  
  
  
  Lütfi Kırdar Kartal Eye Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey.
  
  
  
  Comparative randomized case study.
  
  
  
  Eyes of patients with intumescent white cataract were divided into 2 equal groups. After the anterior capsule was stained with trypan blue, Group 1 received a modified phaco capsulotomy technique and Group 2 received a high-viscosity OVD-assisted capsulorhexis. The OVD used was sodium hyaluronate 2.0% (Protectalon 2.0%) Main outcomes were the capsulorhexis diameters, the deviations from the target diameter, and intraoperative complications.
  
  
  
  Eighty eyes of 80 patients were enrolled. There was a deviation from the target capsulorhexis diameter in 15 eyes (11 oversized, 4 undersized) in Group 1 and in 20 eyes (16 oversized, 6 undersized) in Group 2. Capsule tears during capsulorhexis were observed in 2 eyes in Group 1, and the surgery was changed to extracapsular cataract extraction (ECCE) in 1 eye. In Group 2, capsule tears during capsulorhexis occurred in 22 eyes and 20 of these were managed with ECCE.
  
  
  
  The modified phaco capsulotomy technique might reduce the risk for capsule tear during capsulorhexis, leading to safe cataract surgery in cases of intumescent cataracts.
  
  
  
  None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Genç, Özertürk), Lütfi Kırdar Kartal Eye Training and Research Hospital, and the Eye Clinic (Güler, Çakır), Türkiye Hospital, Istanbul, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Genç
authors.affiliation: From the Department of Ophthalmology (Genç, Özertürk), Lütfi Kırdar Kartal Eye Training and Research Hospital, and the Eye Clinic (Güler, Çakır), Türkiye Hospital, Istanbul, Turkey. Electronic address: guleremre83@hotmail.com.
authors.forename: Emre
authors.initials: E
authors.lastname: Güler
authors.affiliation: From the Department of Ophthalmology (Genç, Özertürk), Lütfi Kırdar Kartal Eye Training and Research Hospital, and the Eye Clinic (Güler, Çakır), Türkiye Hospital, Istanbul, Turkey.
authors.forename: Hanefi
authors.initials: H
authors.lastname: Çakır
authors.affiliation: From the Department of Ophthalmology (Genç, Özertürk), Lütfi Kırdar Kartal Eye Training and Research Hospital, and the Eye Clinic (Güler, Çakır), Türkiye Hospital, Istanbul, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Özertürk
mesh_terms: D019923:Capsulorhexis; D002386:Cataract; D006801:Humans; D007431:Intraoperative Complications; D018918:Phacoemulsification; D014792:Visual Acuity