Frequency of Argentinian Flag Sign in Intumescent Cataract Using Phacocapsulotomy vs Needle Assisted Capsulotomy

Objective: To compare the frequency of capsulorhexis extension with needle assisted capsulorhexis and phacocapsulotomy in intumescent cataract. Study Design: Quasi-experimental study. Place and Duration of Study: Eye Department, Combined Military Hospital, Peshawar Pakistan, from Dec 2021 to Nov 2023. Methodology: After approval of institutional ethical review committee, all the patients having intumescent cataract planned for surgery were included in the study. Each patient underwent complete outpatient ophthalmological work up. Congenital, developmental and traumatic cataract were excluded. Patients planned for surgery were divided in two groups by consecutive sampling technique. After standard temporal 2.75 mm phaco incision, in Group A, patients underwent two stage capsulorhexis initiated with needle and then mini-rhexis with 23 G micro-capsulorhexis forceps and aspiration of lens cortex with Simcoe cannula after which it was completed with micro-capsulorhexis forceps. While patients in Group B, underwent puncturing of anterior capsule with phaco needle and aspiration of soft lens matter with phaco needle followed by completion of the surgery in the standard manner. Results: A total of 83 patients were included in the study. Group A included 41 patients while Group B had 42 patients. Five (6%) patients from Group A and 1(1.20%) patients from Group B had peripheral extension of the capsulorhexis which was retrieved with Little’s maneuver in all the 6 patients. Conclusion: Phaco capsulotomy is safe technique to ensure an intact continous curvilinear capsulorhexis in intumescent cataract as compared to the standard two staged capsulorhexis using micro-capsular forceps.