Volume 7, Issue 4, April – 2022 International Journal of Innovative Science and Research Technology ISSN No:-2456-2165 IJISRT22APR054 www.ijisrt.com 22 Phacoemulsification in White Cataract: Demographic Profile, Associated Difficulties and Visual Outcomes Dr. Sujit Kumar Biswas, Dr. Soma Rani Roy, Dr. Sajjad Hossain Khan, Dr. Kazi Tahmina Akhtar. Correspondence to: Dr. Sujit Kumar Biswas. MBBS, DCO, FCPS, FICO, MRCSGlas, MRCSEdin. Consultant. Department of cornea Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Abstract:- Aim: To evaluate the demographic profiles of the patients, associated problems and visual outcomes of phacoemulsification in eyes with white cataract. Design: A prospective interventional study. Materials & Methods: A prospective interventional study of 76 patients done who had either mature or hyper- mature cataract and underwent phacoemulsification surgery. All pre- and postoperative data were recorded according to the protocol of cataract clinic of the hospital. All surgeries were done under peri-bulbar anesthesia and by single surgeon. In all cases two plane clear corneal incision of 3.2 mm, continuous curvilinear capsulorrhexis (CCC), phacoemulsification by stop and chop and in bag IOL implantation done. CCC was done by two step procedure to reduces the intra-lenticular pressure and prevent ‘Argentina flag sign’. All patients were followed up at 1 st postoperative day, 7 th postoperative day, one month and 3 months. Results: Mean ages was 55.28+9.72 years (ranged 32 to 75 years) and 41% belonged to 51-60 years. Among different occupations, a significant number of patients (43.42%) were housewives and 64.47% patients were from rural areas. About 67% patients had different systemic diseases (diabetes, hypertension, ischemic heart disease, asthma etc.). Mature cataract was 60% and remaining was hyper-mature cataract. Mean phaco-time was 0.27+0.11 minutes. Superior clear corneal incision didn’t cause statistically astigmatic change postoperatively. The final best corrected acuity in good category (6/6 to 6/18) achieved in 98.70%. Ninety two percent patients showed no associated complications. Conclusion: By making good capsulorrhexis with the use of trypan blue and two step procedure that is initial small ‘can opener capsulotomy’ which reduces the intra- lenticular pressure followed by an appropriate capsulorrhexis make the surgery safer and good visual outcome. Keywords:- Phacoemulsification, White Mature Cataract, Hyper-Mature Cataract, With The Rule Astigmatism, Against The Rule Astigmatism, Intraocular Lenses, Continuous Curvilinear Capsulorrhexis. I. INTRODUCTION Cataract is the most common reversible blindness in the world. White cataract or senile mature cataract is an advanced form of cataract disease. [1] A cataract is termed white and mature if the cortex and nucleus become so opaque that the red fundus reflex is absent and the cortex becomes extensively hydrated. In developing countries White mature cataracts are very common scenario in developing countries. [2,3] White cataracts may be divided into three types: 1) cortically mature cataract with diffusely flocculent cortex and may be associated with raised intra-lenticular pressure (intumescent, swollen cataract); 2) mature cortical cataract with flocculent cortex and a hard, brown nucleus; and 3) gelatinous cortex and soft nucleus with uniformly soft cataract. [1] Phacoemulsification of white mature cataract with posterior chamber intraocular lens implantation may associated with higher rate of complications such as difficulty in capsulorrhexis due to fragile capsule, obscure visualization due to leakage of liquefied cortical material and absence of red reflex , and tendency of peripheral capsulorrhexis tear tear because of high intra-capsular pressure. [2,3] The anterior capsule may undergo degeneration with deposition of calcium or development of focal plaques which may interfere with the capsulorrhexis. Due to hardness of nucleus, it usually require a longer time and higher power for phacoemulsification even in expert surgeons. A plaque or residual posterior capsule opacification is observed despite of successful surgery. Thus, surgical removal of white mature cataracts presents special challenges to the surgeon. [2,3] In the present study, we were trying to find out the demographic profiles of the patients, associated surgical difficulties, complications and visual outcome of phacoemulsification in white mature cataract.