Techniques to Avoid Argentinian Flag Sign

In this surgical video, Drs. Daniel Perrone, Luciano Perrone and Ariel Blanco demonstrate 3 techniques to prevent Argentinian flag sign during surgery.

• Small-needle aspiration technique. The capsular bag is stained with trypan blue and then punctured with a 27 to 30-gauge needle to initiate fluid aspiration and bag decompression. However, since the capsule remains under moderate to high tension, surgeons should take care when performing the capuslorhexis as the Argentinian flag sign may still occur. They recommend using small scissors to cut the rhexis, make a new flap and finish the anterior capsulorhexis.
• Modified small-needle aspiration technique. The procedure is performed before making any cataract incisions, eliminating the high tension in the capsule. The key is to use a small needle attached to a syringe.
• Nd-Yag laser anterior capsule capsulotomy. Once the laser makes a small opening to release the fluid and reduce tension, dye and a small air bubble are injected. This small opening, they explain, can then be used to start the capsulorhexis.

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