1021: the nucleus drops during phaco

This anonymously submitted video shows a complication from a resident cataract surgery. The capsulorhexis radializes in the sub-incisional area and then excessive hydro-dissection is performed which allows this weakness to rip to the capsular bag equator and to the posterior capsule. Then the attempt to separate the two nuclear halves places additional stress on the capsule which then causes the posterior capsule to split wide open. The nucleus then falls into the vitreous cavity.

click to learn from this video and how to recover from this complication:


  1. That is a SICK feeling! At this point the less you do the better, tell the patient and call the retinal specialist and pray for a good outcome!

  2. Great video and excellent pearls! One point, the rhexis looks continuous at the end. The posterior capsule probably blew out with over aggressive hydrodissection (a small pupillary snap sign could be seen). Tough when this happens but the patient hopefully will still have a good outcome.

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