Complete Case: loose zonular support

Another great video in our series of Complete Cataract Cases: a dense cataract in the setting of loose zonular support. When we start to perform the cataract surgery we notice that the anterior lens capsule wrinkles extensively when we attempt to perform the capsulorhexis. This surgery is significantly more challenging than a typical cataract case, and we spend more time completing it. The entire case is showcased in the video below and while it does require a 9 minute investment of time, it is well worth it for the learning points.

click below to learn from this complete cataract case:


  1. How did you decide to avoid capsular hooks? When you touched the bag with your rhexis forceps the bag looked quite mobile…

    1. great question! I make the decision when I do the capsulorhexis. If there is enough capsular support to allow me to tear the circular capsulorhexis, then I can go without capsule hooks. If I start to tear the capsulorhexis, but I cannot without using the other hand (and a chopper) to stabilize the capsular bag, then I will likely need capsular hooks.

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