White Cataracts—Tips, Techniques and New Perspective

Abstract

The main scope of this review will be directed toward relevant literature about white cataracts published in the last year that may be useful for daily practice. Significant studies published in previous years may also be cited. Traumatic or other uncommon etiology white cataract reports have not been included. White cataract surgery is challenging in many ways, with capsulotomy being the main aspect of concern. Peripheral extension of capsulotomy is still a frequent concern that can further complicate the procedure and lead to a high incidence of posterior capsule rupture. Improvements in the technique have been suggested and include the use of adequate ophthalmic viscoelastic devices, intralenticular pressure release, or femtosecond-assisted capsulotomy. All of the above have added safety to the procedure. New technologies have also been added to our armamentarium to further facilitate capsulotomy with an adequate cost benefit ratio. Adequate planning and techniques must be considered for a successful outcome in white cataract surgery. Femtosecond laser-assisted cataract surgery may add safety for capsulotomy creation only for specific types of white cataract, but nucleus fragmentation must be considered carefully. Other novel technologies may provide greater safety to capsulotomy in intumescent cataracts. Future research must pursue uniform nomenclature for classification of white cataracts.