Spiral capsulorhexis in intumescent white cataract

Intumescent cataract is characterized by swelling and thickening of the lens due to increased intralenticular fluid accumulation. Capsulorhexis in such cases is particularly challenging due to the risk of anterior capsular rupture (Argentina flag sign), runaway rhexis, and a poor red reflex. Several capsulorhexis techniques have been described to minimise the risk of complications like spiral capsulorhexis, phacocapsulotomy, mini rhexis, and vacuum capsulorhexis. Among them, Spiral capsulorhexis is one of the commonly employed techniques in an intumescent cataract. In this video, we demonstrate the key surgical steps and important precautions for performing spiral capsulorhexis using a cohesive ophthalmic viscoelastic device (OVD) in an intumescent cataract.