Prevention of Argentinian Flag Sign in Intumescent Cataracts Using Anterior Chamber Air Bubble and Cortical Fluid Release Techniques

Objective : To effectively avoide the occurrence of the Argentinian flag sign during the process of continuous, circular, and centered anterior capsulotomy (CCC) on the anterior capsule in cortically liquefied intumescent cataracts Methods: Preoperative examinations including slit-lamp examination, ocular A-scan ultrasonography, and UBM were conducted on 61 patients with intumescent cataracts. Cases with cortically liquefied intumescent cataracts were selected and after staining with indocyanine green, the anterior chamber air bubble technique was used to compress the anterior capsule, and liquefied cortex was aspirated using a puncture needle. CDVA and intraocular pressure were recorded on postoperative days 1, 1 week, 1 month, and 6 month. Intraoperative and postoperative complications were documented and analyzed. Results: Fifty eyes were identified as having cortically liquefied intumescent cataracts. No cases of the Argentinian flag sign occurred, and standard capsulorrhexis was achieved, facilitating smooth phacoemulsification. All patients achieved satisfactory outcomes at follow-ups of 1 day, 1 week, 1 month, and 6 month postoperatively. Mild corneal edema was observed in three cases on the first postoperative day, with no other complications noted. Conclusion: The anterior chamber air bubble technique combined with cortical fluid release technique can prevent the occurrence of the Argentinian flag sign in cortically liquefied intumescent cataracts, this method is simple, convenient and economic for the clinical promotion.