DOI: https://doi.org/10.36347/sjams.2026.v14i04.029

Pages: 614-616

Intumescent cataracts represent a high-risk surgical condition due to increased intralenticular pressure and fragile capsular structures. Preoperative evaluation is often limited by the absence of red reflex and poor visualization of lens morphology. Anterior segment optical coherence tomography (AS-OCT) provides detailed in vivo imaging of lens architecture, enabling identification of key features such as capsular convexity, intralenticular clefts, cortical liquefaction, and compartmentalization. Based on these findings, a morphological classification can be established, allowing indirect assessment of intralenticular pressure and stratification of capsular risk. This approach facilitates prediction of intraoperative behavior and guides surgical strategy. AS-OCT thus represents a major step toward personalized cataract surgery, transforming management from an unpredictable to a predictive model.