This patient has a large cortical opacity in the central visual axis which is distorting the vision tremendously. So while there is a significant cortical cataract, there is very little nuclear density. It is not, however, a butter-soft cataract since this patient is elderly. The mild degree of nuclear sclerosis makes it challenging to perform phaco chop or even stop and chop. This gummy nucleus is not as easy to remove as one may expect. This video shows my approach to these cases and how we can safely and efficiently complete the case.
