Comparative study between phacocapsulotomy and needle aspiration in phacoemulsification of white intumescent cataract

Purpose: To evaluate the phacocapsulotomy technique for management of capsulorhexis in white intumescent cataracts regarding safety and effectiveness in comparison with needle aspiration. Methods: This prospective study included 100 patients with white intumescent cataracts. Patients were randomized into two groups comprising 50 each. Group I underwent phacocapsulotomy technique to facilitate CCC, where phaco probe is used to decompress the lens. Group II underwent needle aspiration technique to facilitate CCC, where 26 gauge needle is used to aspirate cortical fluid. Intraoperative variables such as flap elevation, radial extension of CCC, centration of CCC, posterior capsule rupture and vitreous loss were assessed. Postoperative best corrected visual acuity was also assessed. Results: In our study we found that 1(2%) patient out of 50 patients who underwent phacocapsulotomy technique had radial extension of CCC compared to 8(16%) out of 50 patients in needle aspiration group which was statistically significant (p=0.04) and also there was decrease in intralenticular pressure noted in 44(88%) in phacocapsulotomy group and 26(52%) in needle aspiration group which was statistically significant (p value=0.03). Conclusion: Phacocapsulotomy technique is a simple, controlled and effective technique that extends the possibility of routinely achieving a CCC and thus prevent radial extension of CCC. It also allows for safe phacoemulsification and well centered in the bag IOL implantation.