Hyper mature cataract #
If a cataract remains in the eye for a very long time, the cataractous lens becomes very dense white or brown. This condition is known as the hypermature cataract. It can create serious secondary problems like glaucoma and phacolytic crisis. However, before this would occur, loss of visual acuity would severely affect your everyday activities such as reading or driving.
A morgagnian cataract arises when a cortical cataract becomes hypermature. A cortical cataract is an opacity of the lens cortex or periphery of the lens. An early cortical cataract is often clinically diagnosed by spoke-like or wedge-shaped opacities of the lens, most commonly in the inferior quadrants. as the cataract matures, The lens fibres degenerate, leaving cytoplasmic protein globules between the fibres of the cortical lamellae. Increasing amounts of cortex degenerate with time and the globules begin to coalesce 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.
The Complication Risk Increase with Hypermaturity of Cataract #
Right from the preoperative presentation, hypermature cataracts are considered to be a surgical challenge. Assessing the density of the nucleus and the increased intracapsular pressure is difficult. getting these answers wrong can lead to complications and often the abandonment of the phaco procedure if these issues are not properly handled. These complications cause difficulty in visualizing the capsular margins, jeopardizing the performance of a good capsulorhexis procedure. Furthermore, a hypermature cataract can obscure a hard or brunescent nucleus underneath it with the nucleus often having a flocculent posterior cortical opacity.
The Milky White Cataract #
Hypermature cataracts are pearly white and could have fluid within the capsule. when a high amount of fluid is present and the nucleus size shrinks, it is known as a morgagnian cataract.