Managing Posterior Polar Cataract

Dr. Harshul Tak shows his approach to managing a posterior polar cataract in an adult. After making a 1.8 mm main incision temporally, he uses a 26 gauge cystotome to make a capsulorhexis no larger than 4.75 mm. Without using hydrodissection or hydrodelineation, he begins phacoemulsification using a “slow-motion” technique. To avoid rotating the nucleus, he makes a second 1.8 mm incisions superiorly to reach another section of the nuclear material. He shifts between the temporal and superior incision to complete stripping of the epinucleus and remove the remaining cortical material.  Due to a 4 mm tear in the posterior capsule, he performs a posterior capsulorhexis prior to implanting a single-piece hydrophobic acrylic IOL. At day 1 postop, the patient had a well centered IOL with a BCVA of 20/20.