Managing Capsular Defects

Mayank Nanavaty, FRCOphth manages a traumatic cataract in a 23-year old who suffered a perforation to his cornea, iris, anterior and posterior capsule. He begins with an anterior capsulorhexis and removed the cataract using aspiration and avoids hydrodissection. As he nears the site of the capsular defect, the aspiration flowrate and bottle height are reduced to decrease turbulence. Dispersive viscoelastic is added to plug the posterior capsular defect, followed by implantation of a 3-piece IOL in the sulcus.  At 6 weeks, the patient could see 20/10.