This has happened to all of us! The Argentinian flag sign occurs when the anterior capsule tears peripherally during capsulorhexis in a white, intumescent cataract, as the high intra-lenticular pressure forces the tear toward the equator. Once this happens, the goal is to prevent posterior extension and maintain anterior chamber stability. Immediately refill the chamber with a cohesive OVD to flatten the anterior capsule and counteract lens pressure. Using fine micro-forceps, carefully redirect each radial tear circumferentially to complete a continuous curvilinear capsulorhexis, often converting it into a slightly smaller or irregular shape. Phacoemulsification should be gentle and centralized, minimizing stress on the capsular edge. Despite the radial tears, if the posterior capsule remains intact, the intraocular lens can safely be implanted within the capsular bag, where fibrosis usually stabilizes the tear margins postoperatively. How do you handle this complication?
