07/07/2022
Black cataract is very specific. The lens nucleus has become so hardened, sclerotic and blackened that it has gone beyond what is known as brunescence.
Brunescence is a discoloration of the nucleus that occurs as the nucleus becomes sclerotic.
Brunescence begins as a yellowing and progresses to orange and brown. With the progressive discoloration and opacification, the vision gradually diminishes over time.
Black cataract causes legal blindness meaning the vision is expected to be Hand Motion or Light Perception and not much better.
This presents serious and anticipated risks for planning surgery. With a diagnosis of Black Cataract, the preferred surgical procedure may be a planned Extracapsular Cataract Extraction.
In certain centers, with advanced Laser technology, laser cracking of the lens would be advised prior to phacoemulsification.
With a Black Cataract, increased ultrasonic time and energy are needed to liquefy the denseness of the blackened lens. As such, the patient is at risk for posterior capsular tears, zonular tears and other surgical complications.
The surgeon must be adequately trained to anticipate and manage the surgical risks attendant with removal of a Black Cataract.
In India, untreated Glaucoma has the misnomer of Black Cataract when the damage has caused optic atrophy and irreversible blindness.
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