AC to PC Tear, IOL Removal, and Sulcus IOL Placement

This patient underwent uneventful cataract surgery until the intraocular lens (IOL) was implanted. A preloaded single-piece lens with a straight leading haptic is injected forcefully into the eye, causing an anterior capsular (AC) tear opposite the main wound. The lens is successfully placed in the bag despite this tear; however, during corneal wound hydration, the chamber deepens suddenly, the pupil dilates, and the capsule shakes. A posterior capsular (PC) tear is noted running beneath the full length of the optic. Viscoelastic is injected underneath the lens, which was then cut in half and removed in two pieces. A 3-piece lens is then placed in the sulcus. No vitreous is noted at the wound at the end of the case.