PHACOEMULSIFICATION OUTCOMES IN WHITE CATARACT AND DETERMINANTS OF DELAYED PRESENTATION
Main Article Content
Abstract
Purpose: To evaluate the effectiveness and safety of PHACO surgery on patients with white cataract and to survey the causes of delayed cataract surgery in the community
Methods: This prospective study included patients with white cataracts who underwent PHACO surgery at Sai Gon Vinh Eye Hospital in Nghe An province from June 2025 to December 2025.
Results: The study included 75 patients with white cataract (n = 75) with a mean age of 75.8 ± 9.8 years and a male-to-female ratio of 1:2.1. Of these, 35 eyes had mature white cataract (46.7%), 28 eyes had hypermature cataract (37.3%), and 12 eyes had intumescent cataract (16.0%). Preoperatively, 34.7% of eyes had hand motion visual acuity and 65.3% had light perception only. Postoperatively, the mean logMAR visual acuity was 0.22 ± 0.08. The mean corneal endothelial cell loss rate was 7.7% at one week and 9.3% at one month postoperatively. A moderate positive correlation was found between cumulative dissipated energy and corneal endothelial cell loss rate at both one week and one month postoperatively (r = 0.315; p < 0.05). One case of posterior capsular rupture was recorded postoperatively (1.3%). The most common cause of surgical delay belonged to the psychosocial group (49.3%), primarily due to prior surgery on the fellow eye or fear that surgery might lead to blindness.
Conclusion: PHACO provided good visual outcomes with a low complication rate in white cataracts. Cumulative dissipated energy was associated with postoperative corneal endothelial cell loss. Psychological and social barriers were the main reasons for delayed surgery.
Keywords
Phacoemulsification (PHACO), white cataract
Article Details
References
2. Jaiswal K, Rathi R, Jain A, Gaur A, Nema N. Visual Outcome and Complications in White Mature Cataracts after Phacoemulsification. Middle East African journal of ophthalmology. Jul-Sep 2023;30(3):129-135. doi:10.4103/meajo.meajo_100_23
3. Real L. White Cataracts—Tips, Techniques and New Perspective. Current Ophthalmology Reports. 2020/09/01 2020;8(3):93-98. doi:10.1007/s40135-020-00238-w
4. Chakrabarti A, Singh S. Phacoemulsification in eyes with white cataract. Journal of cataract and refractive surgery. Jul 2000;26(7):1041-7. doi:10.1016/s0886-3350(00)00525-3
5. Watson A, Sunderraj P. Comparison of small-incision phacoemulsification with standard extracapsular cataract surgery: post-operative astigmatism and visual recovery. Eye (London, England). 1992;6 ( Pt 6):626-9. doi:10.1038/eye.1992.135
6. Guigui B, Rohart C, Streho M, Fajnkuchen F, Chaine G. [Phacoemulsification in eyes with white cataracts: results and complications]. Journal francais d’ophtalmologie. Nov 2007;30(9):909-13. La phacoémulsification chez les patients atteints de cataracte blanche: résultats et complications. doi:10.1016/s0181-5512(07)74027-5
7. Gimbel HV, Willerscheidt AB. What to do with limited view: the intumescent cataract. Journal of cataract and refractive surgery. Sep 1993;19(5):657-61. doi:10.1016/s0886-3350(13)80021-1
8. Blanco A, Rocha-de-Lossada C, Navarro P, Lerner SF, Perrone L, Soler Ferrández FL. “White-puncture”: A simple technique to prevent tearing of the anterior capsule during capsulorhexis in intumescent white cataracts. Archivos de la Sociedad Espanola de Oftalmologia. Feb 2021;96(2):97-101. Blancopunción: una técnica simple para prevenir el desgarro de la cápsula anterior durante la capsulorrexis en cataratas blancas intumescentes. doi:10.1016/j.oftal.2020.07.025
9. Dhingra D, Balyan M, Malhotra C, Rohilla V, Jakhar V, Jain AK. A multipronged approach to prevent Argentinian flag sign in intumescent cataracts. Indian journal of ophthalmology. Sep 2018;66(9):1304-1306. doi:10.4103/ijo.IJO_51_18
10. Vajpayee RB, Bansal A, Sharma N, Dada T, Dada VK. Phacoemulsification of white hypermature cataract. Journal of cataract and refractive surgery. Aug 1999;25(8):1157-60. doi:10.1016/s0886-3350(99)00118-2
11. Bilgin B EK, Sezgin BI, Duman M. Comparison of phacoemulsification results of mature and nucleocortical cataracts. Turk J Ophthalmol. 2006;36(4):219–222.