3074: the capsulorhexis ran out – let’s recover now
The Argentinian flag sign is a notorious intraoperative challenge, and because no decompression technique for intumescent white cataracts is 100% completely perfect, it can happen to even the most experienced surgeons. When the anterior capsule splits and tears out toward the equator, the immediate priority is accepting the reality of the run-out and shifting focus entirely to damage control. To prevent the anterior extension from wrapping around to the posterior capsule, the surgeon must putting stress on the capsular bag and exercise hightened caution when manipulating the nucleus. Gentle, low-stress nuclear removal, meticulous fluidic control to prevent anterior chamber shallowing, and careful cortical aspiration are critical to preserving posterior capsular integrity and successfully completing the case. Watch the video to analyze the recovery sequence and learn how to manage an anterior capsular run-out without converting it into a posterior capsule rupture. What is your initial move when an intumescent cataract tear extends to the equator: do you perform a secondary counter-rhexis or pivot straight to a low-energy chop? Please comment your thoughts below.
