Brunescent cataracts are very advanced nuclear cataracts that have become brown and opaque.
A 74-year-old man presented for cataract surgery consultation. On exam, there were red colored dense lenticular opacities consistent with brunescent nuclear sclerotic changes. Special considerations for cataract surgery in these patients include an anticipation that a lot of phacoemulsification energy will need to be employed. Alternatives include extracapsular cataract surgery or manual small incision cataract surgery.
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