Posterior polar cataracts are unusual, but certainly every ophthalmologist will see these patients in their own clinics. While most surgeons see just one or two of these per year, in my clinic we are referred these cases almost monthly. These cases are unusual and there is a high risk for posterior capsule rupture because at the site of the polar opacity, the posterior capsule is weak, fragile, or even absent.
We have posted many videos about posterior polar cataracts in the past and all of them are in agreement that we should NOT perform hydro-dissection for fear of rupturing the posterior capsule. I have advocated using hydro-delineation and then visco-dissection with a dispersive viscoelastic.
This video from Dr. Naveen Gopal from Bangalore, India uses no hydro-delineation. He simply chops the cataract in position and carefully removes each half. It works well and the case goes smoothly.
click below to learn how to fix a posterior polar without hydro-delineation: