The complication of uncontrolled splitting of the anterior lens capsule in an intumescent white cataract is something that all cataract surgeons will face in their careers, usually multiple times. There are ways to help minimize this risk including needle decompression of the capsular bag, the double capsulorhexis technique, and even using the phaco probe to puncture the lens capsule. However, sometimes we will still face the challenge of a split lens capsule and in this case, it is further compounded by having an eye with a prior pars plana vitrectomy. This means that if the split extends to the posterior capsule, the entire nucleus will quickly drop into the vitreous cavity. This is a tricky case and our anonymous guest surgeon handles it very well. One day this will certainly happen during your surgery and by studying this video you will be prepared to recover and give your patient a good visual outcome.
