Some white cataracts are intumescent which means that the capsular bag is filled with liquefied lens cortex. This fluid increases the pressure within the capsular bag and if we allow a pressure gradient to exist, where the pressure in the anterior chamber is less than the intra-lenticular pressure, we can lose control of the capsulorhexis. This is the dreaded Argentinian Flag Sign and it can lead to more complications such as posterior capsule compromise, vitreous prolapse, and poor capsular support for the IOL.
Guest surgeon Dr Naveen Gopal from Bangalore, India presents a technique for dealing with these cases by using the spiral-out method for capsulorhexis creation.
click below to learn the spiral-out capsulorhexis technique: