Wowza, Cataract Coach is speaking a little Spanish!
The Blanco Punción technique, developed by Dr. Ariel Blanco, is used to safely manage intumescent white cataracts and prevent the Argentinian flag sign. In this approach, a fine needle (27–30 gauge) is used to puncture the central anterior capsule first, before any viscoelastic is injected. This initial puncture allows liquefied cortical material to escape from the high-pressure lens, decompressing the intra-lenticular space. Once decompression begins, a cohesive OVD is then introduced into the anterior chamber to stabilize the capsule and maintain space for surgery. With the anterior capsule flattened, a controlled continuous curvilinear capsulorhexis can be completed safely, minimizing the risk of radial tears. The technique is simple, effective, and reproducible, providing a safe way to handle high-pressure lenses while preserving capsular integrity. By addressing the pressure gradient first, it significantly reduces the incidence of the Argentinian flag sign. Have you tried this technique? Please comment below.