3017: Argentinian flag in Expert Hands
Even expert surgeons encounter high-risk intraoperative complications—the true mark of surgical excellence lies in how calmly and effectively you recover to ensure a fantastic visual outcome. In this challenging case of an intumescent white cataract, high intralenticular pressure causes a spontaneous capsular tear to extend rapidly toward the equator, creating the classic Argentinian Flag Sign. The surgeon demonstrates flawless intra-operative decision-making: immediately decompressing the anterior chamber with heavy cohesive viscoelastic, stabilizing the capsular tear edges, and converting the mechanics to complete nuclear removal without allowing the tear to propagate to a posterior capsule rupture. Watch the video to see how meticulous fluidics management, controlled micro-scissors cuts, and deliberate nuclear manipulation turn a potential surgical disaster into a safe, successful IOL implantation inside the bag. When facing a sudden capsular run-out in a white cataract, what is your immediate protocol to arrest the tear and secure the anterior capsule? Please comment your pearls and strategies below.
