Surgical techniques for complicated cataracts: managing dense or white cataracts
Muhammad Ali Ahad1, Enmar M Almazyad
1Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Current Opinion in Ophthalmology
|November 1, 2025
Summary
Recent advances in cataract surgery, including improved imaging and new phacoemulsification systems, enhance safety and predictability for dense white cataracts. These innovations reduce complications and improve refractive outcomes.
Area of Science:
- Ophthalmology
- Surgical Technology
Background:
- Dense white cataracts pose surgical challenges.
- Traditional management methods have limitations.
Purpose of the Study:
- Review recent advancements in surgical management of dense white cataracts.
- Focus on preoperative assessment, biometry, capsulotomy, and phacoemulsification.
Main Methods:
- Review of recent literature on cataract surgery techniques.
- Analysis of innovations in ocular imaging, biometry, and surgical equipment.
Main Results:
- Swept-source optical coherence tomography (SS-OCT) improves axial length measurements in dense lenses.
- Anterior segment OCT and Scheimpflug imaging aid in preventing anterior capsule tears.
- New capsulotomy techniques and femtosecond laser use enhance safety.
- Advanced phacoemulsification platforms reduce energy use and endothelial cell loss.
- Manual small-incision cataract surgery remains viable for very dense nuclei.
Conclusions:
- Technological advancements significantly improve safety and predictability in dense white cataract surgery.
- Incorporating innovations reduces intraoperative complications like capsular tears and posterior capsule ruptures.
- Enhanced refractive outcomes are achieved with modern surgical approaches.
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