We have featured many videos about posterior polar cataracts and the techniques that can be used to successfully operate on these patients. The primary issue is that the posterior capsule is weak, fragile, or even absent at the site of the posterior polar opacity.
The key message is to avoid hydro–dissection since this can rupture the posterior capsule! We must perform only hydro–delineation.
If you have been learning from CataractCoach.com then you have already learned from many posterior polar cases. The techniques that we have featured before include:
- visco-dissection in a softer nucleus
- visco-dissection in a dense nucleus with a smaller pupil
- visco-dissection by a resident surgeon still in training
- nucleus bowl-out technique by a guest surgeon
- hydo-delineation technique by a resident surgeon
- an open central capsule with partial anterior vitrectomy
- a posterior polar that was not discovered until the day of surgery
This technique is different and it is something that I have never seen before. The guest surgeon is Neto Rosatelli MD from Brazil and he uses the chopper to mechanically separate the epi-nucleus from the capsule. It is impressive and I want to try this technique in the future.
Click below to watch Dr Neto Rosatelli’s technique of posterior polar cataract surgery:
Please let Me know what’s the name of the chopper that Dr. Neto uses. Even I follow horizontal chopping. Plz guide me sir. Thanks
excellent surgery
I had under the impression that we should not rotate the nucleus or epinucleus as there can be adhesions at the posterior pole which can rift the posterior capsule,
kindly comment
I agree — my preferred technique for posterior polar cataracts does not involve any rotation. With CataractCoach we want to present all the different ways to approach these cases and then let our viewers decide which would work best in their hands.