This patient is young, about 30 years old, and he developed a very dense and large posterior sub-capsular opacity which has significantly dropped his vision. He just can’t function normally and now he desires cataract surgery. The challenge is the limitation of our IOLs: there is no man-made lens implant which functions as well as a young, normal human crystalline lens. The patient has absolutely no cataract in the other eye, which sees 20/20 for far and near due to the large degree of accommodation. We have chosen to implant a monofocal, aspheric IOL with a goal of plano in this eye.
The cataract itself is very soft because there is no nuclear sclerosis. So soft that we do not even need the phaco probe to remove the cataract — we can just use the irrigation / aspiration (I/A) probe with high suction. We also make a special consideration for the capsulorhexis size because we are anticipating more capsular contraction and fibrosis compared to a geriatric patient.
Click below to watch the technique in a very soft PSC cataract:
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