Science & Clinical Research

1. We present a modified single-stage capsulorhexis technique for intumescent white cataracts using an 18-gauge needle
2. Peripheral needle entry allows controlled decompression and minimizes the risk of radial capsule tears
3. Biomechanical analysis based on Laplace’s Law supports the safety of the peripheral puncture site
4. In our study, continuous curvilinear capsulorhexis was completed successfully in 98.9% of cases
5. This simple and reproducible method offers a safe solution for managing high-risk cataracts in daily practice

This study presents a modified single-stage continuous curvilinear capsulorhexis technique designed to improve safety and control in intumescent cataracts. The method uses a peripheral needle entry to achieve gradual decompression of the capsular bag, minimizing sudden pressure shifts that can lead to capsular extension. By applying biomechanical principles consistent with Laplace’s law, the technique redistributes capsular tension and reduces stress on the anterior capsule during puncture and tearing.

We evaluated the feasibility, safety, and reproducibility of this approach in a clinical series. Controlled decompression enabled stable anterior capsule management and facilitated completion of a well-centered, continuous capsulorhexis in all cases. Intraoperative complications related to capsular run-out were avoided, and postoperative lens positioning remained stable. The technique integrates seamlessly into standard phacoemulsification workflow without requiring additional devices or complex steps.

Our findings suggest that this simplified approach enhances surgical predictability while preserving capsular integrity. Because it relies on familiar instruments and clear biomechanical rationale, the method is easily adoptable and suitable for a wide range of surgeons. This modified capsulorhexis strategy offers a practical and effective solution for managing high-risk intumescent cataracts, supporting safer surgery and consistent visual outcomes.