Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2023; 11(29): 7150-7155
Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7150
Surgical treatment of severe anterior capsular organized hard core cataract: A case report
Li-Wen Wang, Shi-Feng Fang
Li-Wen Wang, Shi-Feng Fang, Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian 116000, Liaoning Province, China
Author contributions: Wang LW performed the data analysis; Fang SF performed the development or design of methodology; both authors have read and approved the final version of the article.
Informed consent statement: The study participants have provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflict of interest related to this report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Feng Fang, MD, PhD, Chief Physician, Department of Ophthalmology, The Third People's Hospital of Dalian, No. 40 Qianshan Road, Ganjingzi District, Dalian 116000, Liaoning Province, China. stonecrest@sina.com
Received: June 19, 2023
Peer-review started: June 19, 2023
First decision: August 9, 2023
Revised: August 15, 2023
Accepted: September 25, 2023
Article in press: September 25, 2023
Published online: October 16, 2023
Processing time: 111 Days and 13.9 Hours
Abstract
BACKGROUND

Complicated cataract surgery is challenging, especially in cases of hard nuclear cataract with severe anterior capsule organization. It is important to avoid the risk of surgery and improve the surgical skills of surgeons.

CASE SUMMARY

A 60-year-old man presented with severe cataract and visual impairment. The anterior capsule of the lens was irregularly organized and pulled to the surrounding capsule, and white porcelain organized cord and brown-black lens nucleus were clearly visible. In phacoemulsification, maintaining the anterior capsule round and intact plays a key role in a successful surgery. In this case, if the conventional capsule treatment method was used, the anterior capsule would be torn. Therefore, we adopted a segmented anterior capsule treatment method, and a blasting method to release energy when dealing with the lens nucleus, and achieved good surgical results.

CONCLUSION

Complicated cataract surgery is challenging and requires precise skills. Operation plans should be made reasonably to predict the risk of surgery, and improve the visual quality of the patients.

Keywords: Complex cataract; Surgery treatment; Hard core cataract; Clinical treatment; Anterior capsular organized; Case report

Core Tip: This report aims to guide clinicians on the issues they should pay attention to when dealing with complex cataracts, and on the surgical techniques. We report a 60-year-old male patient with severe cataract and visual impairment. The severe anterior capsular organization and the hard lens nucleus made the operation difficult. We adopted an ingenious surgery which mainly focused on two aspects. First, when dealing with the anterior capsule of the lens, the ingenious operation is applied to avoid the anterior capsule tear and serious complications. Second, when dealing with extremely hard nuclear cataract, the surgical parameters are adjusted, which greatly protects the intraocular tissue while removing the cataract.