In this challenging case involving a dense brunescent nucleus, we are met with an unexpected hurdle after the lens material has been successfully cleared. A significant posterior capsule plaque is revealed, sitting directly in the central visual axis and threatening the final visual outcome. When you encounter this, your first instinct might be to aggressively scrape the capsule, but you must be incredibly cautious not to cause a rupture. You can first try to hydro-polish the plaque away or use a polished irrigation and aspiration tip to gently see if it can be peeled. In this case the surgeon uses forceps and is able to completely remove it while keeping the posterior capsule intact. If the plaque is too fibrotic and firmly adherent, the best move is often to leave it alone, finish the case with a standard lens implantation, and then perform a YAG laser capsulotomy a few weeks later once the eye has quieted down. Would you have attempted this peeling with forceps or would you just wait and do a YAG later?
Great case but at the end of the peeling, I would have moved nasally in lieu of coming directly out the wound and would have had more counter traction.
I like the diamond polishers but have now read articles on retinopathy: https://pmc.ncbi.nlm.nih.gov/articles/PMC7154276/