1116: how to clean this scarred capsule

In this case of a dense posterior sub-capsular (PSC) cataract, there is some scarring of the posterior capsule. It is just to the side of the visual axis but it is opaque and central enough to affect the vision. How should we clean this up? What would you do in this case?

click to see my approach (and a bonus clip of a guest surgeon’s approach) to capsule scarring:


  1. You could try injecting a dispersive viscoelastic at edge of the scar to see whether you can create a cleavage plane. This works the best with the posterior capsule slightly convex and with a side-to-side motion.

  2. I agree with you why open the capsule and risk vitreous loss and CME remember the old saying keep it simple stupid!

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