Collapse of the capsular bag during cortex removal

This is a continuation of the case from yesterday, you can review it here. In that case, the phaco probe inadvertently punctured the capsular bag at the equator during attempted removal of a hemi-nucleus. Now during cortex removal, fluid from the inflow will go through this capsular opening and collect in the anterior hyaloid space. This results in a posterior pressure which then causes the capsular bag to collapse, making cortex removal more challenging.

This capsular break is so subtle that the surgeon does not realize it and an attempt to implant a single-piece toric IOL is made. This IOL is inserted into the capsular bag but when it is rotated into position, the degree of capsular compromise becomes apparent.

Click below to learn from this very educational case: