If the posterior capsule ruptures while you have most of the nucleus still inside the eye, the best decision may be to covert to manual extraction of the nuclear halves. Continuing to phaco while attempting to lift up the nuclear halves with visco-elastic is not going to be easy and it runs the risk of extensive vitreous prolapse and displacement of cataract pieces into the vitreous cavity. When you realize that the posterior capsule is wide open and you are in danger, can you quickly and safely convert to MSICS? This video shows me helping a senior resident efficiently convert to MSICS and remove the entire nucleus safely. This is a must see video that will certainly help to rescue you from this sticky situation in the future.
