I really enjoy watching surgical videos from Dr. Neto Rosatelli from Ribeirão Preto, Brazil because he mixes his high degree of surgical skill with clever innovations. In this video, he demonstrates his preferred technique for posterior polar cataracts. We have covered that topic extensively and those videos can be reviewed here. The posterior capsule can be fragile, weak, or even partially absent at the site of the polar opacity. This makes hydro-dissection very risky with studies showing a high rate of capsular rupture. For posterior polar cataracts, we typically advise against hydro-dissection and instead perform hydro-delineation and then visco-dissection. Dr. Rosatelli prefers using a blunt hook to mechanically separate the cataract from the capsule and the results are impressive. Note that this technique requires a high degree of surgical skill and the ability to operate equally well with both hands.
click to learn from this expert level innovative technique for posterior polar cataracts:
What’s happening when the incisions turn frosty at the end? Hydrating and sealing?
see here:
https://cataractcoach.com/2020/10/02/corneal-phaco-incision-hydration/
Awesome video! Does the phaco probe have to be in the eye for mechanical separation? Could’nt you put in Viscoat and then do the mechanical separation or does the maneuver likely cause the Viscoat to burp out of the main incision?
sure, you could do visco-dissection as shown here
https://cataractcoach.com/2018/05/18/successful-posterior-polar-cataract-surgery/