This is a case of MSICS, which is important to learn even if you feel that you can “phaco anything” with your ultrasonic probe. The patient has an intumescent white cataract and as the capsulorhexis is performed (through the large MSICS incision), the anterior chamber shallows and the rhexis runs out. This could have been mitigated by decompression of the fluid-filled capsular bag and by using a small incision to perform the capsulorhexis and then enlarging it for MSICS and nucleus expression. How will you recover from this complication now?
