1439: save this case of capsule rupture

Our guest ophthalmologist is Dr Cathy McCabe from Florida, USA and she is truly a master surgeon, having done tens of thousands of cataract procedures. The mark of a true master surgeon is when she notices a complication and stays calm, accepts reality, takes appropriate measures, and gives the patient an outstanding visual outcome. She expertly shows that though we all tend to feel denial when a complication occurs, the better move is to accept reality. She then takes appropriate measures by keeping the AC inflated while injecting viscoelastic to prevent vitreous prolapse. The posterior capsule rent is the converted into a posterior capsulorhexis for added strength and stability. And then the originally chosen IOL can safely be implanted in the capsular bag. An added bonus: the patient will not need a future YAG laser capsulotomy!

link here


  1. Great case! It would be nice to see the cortex and viscoelastic removal on this case. I feel that these steps get complicated when the posterior capsule is violated and it would be nice to see how Dr. McCabe approached them. Also, would you give this patient oral diamox after the case knowing that you would most likely would get an IOP spike due to not removing viscoat behind the optic (I’m assuming that Dr. McCabe did not go behind the optic to remove viscoat)?

  2. Dear dr fisher
    I dont agree with removing viscoelastic behind the IOL as it will worsen the vitreous prolapse.
    About the cortical material, I guess they remained

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