adherent posterior capsule plaques

You are doing cataract surgery for a patient with a dense nucleus, an advanced cataract, with barely count fingers vision. Once you remove the nucleus and the cortex you notice that there are plaques on the posterior capsule which are not easily removed. What is your next step? Keep trying to vacuum these opacities? Perform a primary posterior capsulorhexis? Or wait and do a YAG laser capsulotomy in a few months?

from a dense (count fingers) cataract, to this result — a beautiful outcome but not quite perfection. Should we go for perfection?

Click below to learn my approach to adherent posterior capsule opacities:

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