Handling complications
'Treat all posterior polar cataracts as though there is a pre-existing hole in the capsule'
Leigh Spielberg
Published: Friday, February 17, 2017
Catarina Pedrosa MD
If the capsule ruptures, do not immediately remove the instrumentsAn alternative is viscodissection, which also forms a cushion and will help avoid vitreous prolapse into the bag in case of posterior rupture. Rudy Nuijts MD, PhD, Maastricht, The Netherlands, agreed, and said he often takes it a step further, luxating the nucleus into the anterior chamber for removal far away from the posterior capsule. If the capsule ruptures, do not immediately remove the instruments, and especially the irrigation, from the eye. Immediately inject viscoelastic to prevent vitreous from entering the anterior chamber. When placing a sulcus lens, increase the incision size and consider capturing the optic in the anterior capsulotomy. “Treat all posterior polar cataracts as though there is a pre-existing hole in the capsule, performing slow-motion surgery to minimise all risk,” added Dr Pedrosa.
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