Monochromatic Phacoemulsification: An Approach for Eyes With Impaired Red Reflex Secondary to Proliferative Diabetic Retinopathy

Phacoemulsification requires good visualization of the lens components, which can be challenging during combined vitrectomy. We discuss using the monochrome filter of the NGENUITY® visualization system (Alcon Laboratories, Fort Worth, Texas, United States) for phacoemulsification in complex cases with diminished red reflex, associated with proliferative diabetic retinopathy. Phacoemulsification and 25-gauge vitrectomy were performed by a single surgeon on 12 eyes of 12 consecutive patients with compromised red reflexes, using the 3D digitally assisted visualization system NGENUITY® with a monochrome filter. Following cataract extraction, a standard 25-gauge pars plana vitrectomy was performed. The procedure was completed successfully without complications in all cases. The NGENUITY® monochrome filter enhanced the contrast of ocular structures during continuous capsulorhexis and cortical material removal. This visualization approach was particularly beneficial for phacoemulsification in cases with reduced red reflex due to proliferative diabetic retinopathy, facilitating the procedure and potentially reducing surgical complications like posterior capsule rupture.