Capsulorhexis in eyes with phacomorphic glaucoma.

Phacomorphic glaucoma is a common condition in developing countries. Extracapsular cataract extraction with a sulcus-fixated intraocular lens (IOL) is associated with increased intraoperative and postoperative complications in this condition. We developed a technique that allows a safe, controlled capsulorhexis in the presence of the shallow anterior chamber, increased anterior capsule convexity, and high intralenticular pressure seen in eyes with phacomorphic glaucoma. The intumescent cataracts are decompressed by filling the anterior chamber with viscoelastic; a 30 gauge needle is then used to aspirate liquid cortex, which facilitates a controlled capsulorhexis. This allows safe phacoemulsification of the cataract and in-the-bag IOL implantation.