Full moon capsulorhexis, a novel technique: Assessment of surgical outcome in patients of intumescent cataract

PURPOSE: To assess the safety and reproducibility of a two-stage mid-peripheral approach for anterior capsulorhexis by the full moon capsulorhexis technique (FCT) for intumescent cataract. METHODS: A retrospective analysis of clinical and surgical records for consecutive cases of intumescent cataract in which the FCT was used by a single surgeon during the study period (24 months). Eyes with pre-existing corneal opacity, phacodonesis, pseudo-exfoliation, capsular fibrosis, glaucoma, pre-existing ocular inflammation, inadequate mydriasis (a pupil diameter less than 6 mm), history of ocular trauma, and history of previous ocular surgery were excluded. Patient demographics (age, gender, comorbidities), size of primary capsulorhexis (PCC), size of secondary capsulorhexis (SCC), type of lenticular cortical fluid egress after initial nick of anterior capsule (F), complications, and surgical time were collected. Descriptive analysis (range (R), mean, standard deviation (SD)) of data was done. RESULTS: There were 110 eyes of FCT in the study period: male: n = 35 (31.82%), female: n = 75 (68.18%); mean age: 51.84 years (R: 25-65 years); comorbidities: n = 83 (75.45%) of hypertension (37.27%, n = 41), type 2 diabetes mellitus (20.90%, n = 23), or both (17.27%, n = 19). Mean PCC was 1.61 mm (R = 1-3 mm; SD = 0.66). Mean SCC was 5.22 mm (R = 4-6 mm; SD = 0.50). F was 'no fluid release': n = 64 (58.18%), 'minimal fluid release': n = 37 (33.64%), and 'profuse milky fluid release': n = 9 (8.18%). There were no complications in PCC or SCC creation. The mean surgical time was 5 minutes 6 seconds (R = 3 minutes 35 seconds to 7 minutes 15 seconds). CONCLUSION: The mid-peripheral approach for anterior capsulorhexis in intumescent cataract by the full moon capsulorhexis technique was safe and reproducible in this series of cases.