Cannula-vacuum continuous curvilinear capsulorhexis: Inexpensive technique for intumescent total cataract.

We report a new, inexpensive technique for creating a continuous curvilinear capsulorhexis (CCC) for intumescent total cataract. Peribulbar anesthesia is administered. A nick is created using a regular 26-gauge cystotome. Through a side port, the free capsule flap is vacuumed using the flat tip of a 25-gauge round cannula connected to a 5 mL syringe. Suction pressure is created by withdrawing the piston of the syringe in a controlled motion to create a curvilinear capsulorhexis without withdrawing the instrument from the anterior chamber. Next, liquefied cortex is aspirated with the same cannula. Complete vacuum was achieved with the cannula in 197 (98.5%) of 200 cases; 3 cases (1.5%) had capsulorhexis extension and vacuum was not achieved. The new cannula-vacuum CCC technique is safe and affordable and might be an alternative to conventional CCC performed using a 26-gauge cystotome or a Utrata or micro capsulorhexis forceps.