management of a dropped nucleus

This is a rare complication that can happen to any patient so the surgeon must know how to effectively manage this situation and help the patient achieve a good visual outcome. This case is being performed by a resident in training and there is a posterior capsule rupture. While some of the cataract is removed, some of it falls into the vitreous cavity. The first step for the surgeon is to accept that this complication has happened, to stay calm, and avoid denial. The anterior segment is cleaned thoroughly and, depending on the case, a three-piece IOL can be implanted in the sulcus, with or without optic capture. The patient will then need a pars plana vitrectomy and lensectomy performed by a vitreo-retinal colleague shortly thereafter. The visual outcome for these patients can be quite good as long as the cataract surgeon follows certain guidelines.

Click below to learn how to manage a dropped nucleus during cataract surgery: