Management of Capsulorhexis in Rock Hard or Mature Cataracts in Elderly without Capsule Staining

Kıvanç S. A., Akova B.

ASCRS , Washington, United States Of America, 22 - 26 April 2022, vol.1, no.1, pp.1

  • Publication Type: Conference Paper / Summary Text
  • Volume: 1
  • City: Washington
  • Country: United States Of America
  • Page Numbers: pp.1
  • Bursa Uludag University Affiliated: Yes



It is difficult to perform capsulorhexis in mature or rock hard cataracts due to poor visualisation.Therefore the anterior capsule is stained with trypan blue.In this study we evaluated the patients aged 75 years old and older who underwent phacoemulsification without capsule staining using author’s own technique for mature and rock hard cataracts


Forty-two eyes of 41 patients aged 75 years and older who underwent phacoemulsification during last year for mature and rock hard cataracts were included in the study. Twenty-two patients were female and 19 were male.The mean age of the patients was 79.6 years ( range: 75-90 years) All the surgeries were performed by one experienced surgeon. ( BA).


Out of 42 eyes the anterior capsule was stained in 5 eyes because of poor visualization both due to mature cataract and central corneal scar. In 37 eyes CCC was performed without capsule stain by using 23 Gauge microcapsular forceps with the surgeons’ self technique. In 5 eyes with capsule staining, one eye developed peripheral extension of the capsule , in one eye posterior capsule rupture was noted. In 37 eyes without capsule staining, no capsule related complications were noted. All CCCs were performed uneventfully. In 2 eyes zonuler dehiscence was noted. In one of them capsular tension ring was placed. In one eye the main corneal incision was sutured due to iris prolapse.


In patients aged 75 years and older with mature and rock hard cataracts CCC without capsular staining can be achieved without any capsulorhexis related complications using proper technique in experienced hands helping to increase the safety throughout the surgery