Comparison of single stage and two stage capsulorhexis in intumescent cataract surgery: A prospective study in a tertiary eye care center in Eastern India

Abstract

Introduction- In eyes with intumescent cataracts, creation of continuous curvilinear capsulorhexis is difficult due to high intralenticular pressure and there is high chance of radial extension of capsular tear. Aim- To compare the results of conventional single stage and two stage capsulorhexis in intumescent cataract surgery. Material and method- A prospective, randomized, interventional study done in a tertiary eye care institute, RIO RIMS Ranchi, India. Seventy four patients of intumescent cataract undergoing phacoemulsification were randomized into two groups. Group I underwent conventional single stage continuous curvilinear capsulorhexis. Group II underwent two stage capsulorhexis in which, initially rhexis of 2.5-3mm size was made and after decompressing the lens, rhexis was enlarged to 5-5.5mm. The data was analyzed using SPSS for Windows software (version 18.0, SPSS Inc., Chicago, IL, USA). Group differences in the continuous variables and categorical variables were analyzed using the student’s T test and the Fisher’s exact test respectively. Result- The study included 74 eyes of 74 patients (41 female and 33 male). Group-1 included 36 patients and group-2 included 38 patients. Radial extension of rhexis occurred in 19.4% and 5.26% of cases in group I and group II respectively. This difference was statistically significant (p< 0.05). Argentinian flag sign were seen in 3 eyes (8.3 %) in group I and in 1 eye in group II (2.6 %). None of the patient in either group had posterior capsule rupture. Conclusion- Two stage capsulorhexis is safer than single stage capsulorhexis and helps to prevent radial extension of capsulorhexis and makes surgery uneventful.