1708: why did this nucleus drop so fast?

This resident case started out pretty well with a good incision and then an intact capsulorhexis, but then things quickly went south and the nucleus ends up on the macula before ever placing the phaco probe inside the eye. Why? What happened here? What were the issues? What are the clues in this video that allowed me to predict that there would be serious complications? You can either learn from this video and prevent this problem in your surgeries or you can skip this one and then just wait until this complication happens to you…

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1 Comment

  1. interesting case. No snap sign during hydrodissection leading me to think there was already some break in the pc from the prior ppv. One of the take homes to me is in a similiar case with prior retinal intervention, wirh such a small pupil, use a malyugin ring early on to allow a larger rhexxis. This will help visualization and help prevent pc blowout. Also before doing the hydrodissection, a deep central groove wirh the phaco can help release pressure from the subsequent fluid wave during hydrodissection

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