Different faces of the white cataract: A phaco surgeon's perspective

Purpose: To develop a system of categorizing white cataracts so that the sa lient features, as would be pertinent to phacoemulsification surgery, could be recognized pre-operatively, Methods: Patients with total cataracts were carefully evaluated using slit- lamp biomicroscopy and slit-lamp photography. An attempt was made to determ ine whether pre-operative evaluation could ascertain the presence or absenc e of features of these cataracts that often cause surgical difficulties, na mely, increased intralenticular pressure (ILP), milky cortex and brown nucl ear colour: Results: Using a standardized method of biomicroscopic evaluation, it was f ound that the status of the ILP, cortex and nuclear colour could be determi ned consistently. Surgical strategies based on such a system of categorizat ion has permitted white cataracts to be consistently managed using phacoemu lsification. Conclusions: Systematic pre-operative evaluation and categorization of whit e cataracts based on the I LF: status of the cortex and nuclear colour can permit proper surgical planning and successful management of such cases wit h phacoemulsification.