1445: rubbery brunescent cataract

There is a pleasure in helping patients with a dense brunescent cataract: we enjoy the surgical challenge and the patient benefits from a vast improvement in vision. This patient waited and waited for cataract surgery because of the delays due to COVID-19. She had a prior pars plana vitrectomy for a retinal detachment a few years ago and then developed a dense nuclear cataract. This nucleus seemed to be rubbery and it just did not want to split. It took quite a bit of persistent effort to sub-divide and emulsify this cataract, but eventually we succeeded. My approach here was to get the chopper behind the posterior plate of the nucleus so that a higher amount of force can be applied. Trapping the nucleus between the chopper and phaco tip is better than simply using the vacuum of the phaco probe to hold the nucleus.

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