In this resident surgeon case, the anterior chamber flattens and there is loss of viscoelastic upon attempted manipulation of the IOL. The resident surgeon will now struggle to finish this case and the surgical time will double. We must always float in the incision and pivot our instruments to avoid gaping the incision. If the incision gapes, then the cohesive viscoelastic will quickly leak out of the eye, much more so than with a dispersive viscoelastic. See this review for a reminder of the differences between cohesive and dispersive viscoelastics.
What is your approach to fix this case? What is the issue with the initial IOL placement? Do you need more viscoelastic to finish the case?
click below to learn from this surgeon’s struggle to position the IOL: