NEEDLE DECOMPRESSION CAPSULOTOMY AS A SAFER ALTERNATIVE TO STANDARD CAPSULORHEXIS IN SURGERY FOR HYPERMATURE AND INTUMESCENT CATARACTS: A COMPARATIVE STUDY IN SAMARKAND.

Abstract

This paper reports a comparative clinical observation of needle decompression assisted capsulotomy, referred to here as phacocapsulotomy, against standard continuous curvilinear capsulorhexis in the surgical management of hypermature and intumescent cataracts. The study was carried out at the Samarkand branch of the ophthalmic surgical service between 2023 and 2025 in 68 eyes with overripe or swollen lenses, thirty four of which were treated with each technique. Phacocapsulotomy involved creating a small controlled vent in the anterior capsule with a bent twenty six gauge needle, followed by gradual release of liquefied cortical material before completion of the capsular opening. In this series, phacocapsulotomy was associated with a higher rate of complete, tear free capsulotomy, fewer radial tears and posterior capsular ruptures, and no observed cases of the so called Argentinian flag sign, a sudden uncontrolled radial tear characteristic of white intumescent cataracts. In two eyes with weakened zonular support, an Alloplant biomaterial patch, a freeze dried allograft originally developed at the All Russian Center for Eye and Plastic Surgery in Ufa and used under licence at the Samarkand clinic, was applied to reinforce the capsule, with an uneventful outcome in both cases. Given the modest sample size and the absence of formal statistical testing, these findings should be regarded as a preliminary clinical observation consistent with previously published needle decompression techniques rather than as definitive proof of superiority, and they support further, adequately powered comparative studies