Objective: To discuss how to choose the methods of capsularhexis and phacoemulsification in cases with mature or hypermature cataract.
Methods: On fifty-nine mature or hypermature cataract patients, continuous circular capsularhexis or can-opener capsulotomy was performed. The nucleus was emulsified by the method of divide and conquer or phaco chop or rotatory carousel in the bag or at the plane of iris.
Results: Continuous circular capsularhexis was successful in 51 cases, failed or shifted to can-opener in 8 cases. There were posterior capsular rupture in 1 cases, partial dehiscence of the zonule in 1 cases and iris bitten by the phaco tip in 1 cases. Postoperatively, there were mild corneal edema in 6 cases and iris posterior synechia in 1 cases.
Conclusion: Continuous circular capsularhexis is the key point to obtain a successful phacoemulsification for mature or hypermature cataract. Hydrodissection is not important before the phacoemulsification. Skillful phaco chop can reduce the surgical manipulation and the postoperative reaction.