Comparison of nuclear size in mature and hypermature cataract

Introduction: Senile white cataracts are special cases in cataract surgery since they are associated with unique set of complications not seen in immature cataracts. The major drawback while operating on a white cataract is lack of nuclear details like its density or size. This study was conducted to establish nuclear size in mature and hypermature senile cataracts. Materials and Methods: The study involved intact nucleus obtained during manual small incision cataract surgery. The cases were grouped into mature or hypermature category. The nucleus was measured directly using electronic scale on a smartphone calibrated to measure up to 10 micrometers. The thickness and diameter of nucleus were recorded. These values and ocular parameters obtained by immersion A-scan preoperatively were analyzed. Results: The mean nuclear thickness in mature cataracts was 3.66 mm (3.17 to 4.38) and in hypermature cataracts was 3.36 mm (2.66 to 3.95). There was significant difference in nuclear thickness and lens thickness between the two groups. The nuclear diameter did not vary significantly between the two groups. Conclusion: The nucleus in mature cataract is significantly thicker than that of hypermature cataract and occupies most of the lens volume indicating a dense nucleus. During phacoemulsification of mature cataract, it is advisable to increase the machine parameters to tackle this dense nucleus. While in case of hypermature cataract the machine parameters should be lowered as, the nucleus is thinner and less dense.