Topical Phacoemulsification in white mature cataract is one of the most difficult anterior segment procedure.

White, mature, senile cataract is an advanced form of cataract disease. As the cataract matures, the lens fibers degenerate, creating large accumulations of liquefied lens protein. When the majority of the cortex is affected, the lens nucleus is left floating in the liquid cortex, forming a Morgagnian cataract. Eyes with hypermature or mature cataracts may develop a form of secondary elevated intraocular pressure (IOP) referred to as Lens Induced Glaucoma or specifically the, phacolytic glaucoma. Raised IOP must be controlled medically before surgery, this usually takes 3 to 5 days.

Phacoemulsification of white cataract poses particular challenge to the cataract surgeon as the continuous curvilinear capsulorrhexis is more difficult to complete due to loss of red reflex, increase in intracapsular pressure, and occasional leakage of lens matter from the anterior capsule puncture site. An intact complete CCC is critical to minimize the risk of capsular tear and to ensure stable in-the-bag intraocular lens (IOL) implantation .

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