In this surgery, the posterior capsule will rupture and the nucleus will drop into the vitreous cavity. When do you first notice signs of trouble? Watch the video carefully and determine when the initial complications happen. Remember that the complication of posterior capsule rupture and displaced lens fragments into the vitreous cavity will happen to ALL cataract surgeons. This is a known complication and the tissues are very delicate. The posterior capsule is only about 4 microns thin, which is about 1/20th the width of a strand of hair. And the cause of rupture is not purely iatrogenic in all cases but can also be the result of weaknesses in the patient’s tissues. The key is to accept that the complication has happened and then to recover. In this case that means letting the nucleus fall into the vitreous, cleaning the anterior segment, and then sending the patient to a vitreo-retinal colleague for a pars plana vitrectomy and lensectomy. The patient can still have a very good outcome.
