What problems can we expect while doing cataract surgery in White Cataracts?
1) Absence of red reflex: Use Trypan blue to stain the anterior capsule aiding in better capsulorhexis.
2) High intralenticular pressure: IV mannitol can be given prior to surgery.
3) Leaking of liquified cortex: Can impair visibility of the anterior capsule. Use a 26G needle for aspirating the cortex.
4) Fragile anterior capsule: tear easily and prone to radial extension.
5) Running away of rhexis: Make a CCC of 4mm as it is easier to recover if it extends.
6) Argentinian flag sign: Can occur in intumescent cataracts. Decrease the positive pressure in the eye before attempting capsulorhexis.
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