This seemed like a routine cataract surgery, but I was wrong. I just could not seem to chop this cataract and it took me most of the case to figure out why. The cataract is not particularly dense, the zonular support is good, and the phaco machine is properly calibrated and set-up.
The answer is in the photo above, but I’m confident that 99% of surgeons will not figure it out. I did not figure it out until well into the surgery when I was inserting the IOL into the eye. Then it became so obvious to me.
click below to watch the video and see the answer (zoom to 3:54 if you’re impatient):