Finishing this case will be difficult

The reason why ophthalmologists need to perform at least 1,000 cataract surgeries until they are sufficiently up the learning curve, is because there are unusual issues that happen rarely. This is such a case, where the cataract surgery proceeds normally until it is time for cortex removal. Then we have a challenge where the capsular bag collapses and it becomes very difficult to remove the last bit of cortex. IOL insertion is also a challenge — why? What happened to this eye that we are facing such a challenge? And how can we successfully finish this surgery?

Click below to learn from this important video — one day you will face this challenge!


  1. Thank you for sharing this video. Should be there any special caution in YAG capsulotomy of the patients with zonulysis? Is it possible for the bag to be dislocated by the shock wave of the laser?

  2. Although this turned out well in your hands, it is often helpful to have the patient wait in the post op area and return in an hour when the misdirected fluid has been resorbed. Although inconvenient, it is safer for the corneal endothelium and capsular bag.

    1. Good input and thanks for the feedback. Your option would work well, particularly if you also give the patient a little IV mannitol to further desiccate the eye

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