PROPOSED INTERVENTIONS TO REDUCE THE INTRAOPERATIVE COMPLICATIONS ASSOCIATED WITH INTUMESCENT CATARACT

1. Stain the capsule with trypan blue and fill the AC with a high-viscosity OVD (as described in the previous section Poor Red Reflex).

2. Prior to capsulotomy, place a 25- or 27-gauge needle attached to a syringe at the center of the anterior capsule. While suction is applied, use the needle to pierce the anterior capsule, and aspirate the milky cortex. This decompresses the lens to avoid radial extension of the CCC.

3. Use a cystotome attached to the OVD syringe during creation of the CCC to enable injection of additional OVDs, which will clear away the milky egress.

4. Use caution during phacoemulsification, because the freely mobile lens, without an epinuclear barrier, makes segmentation challenging.