DEC 01, 2009
This video demonstrates 2 different but equally effective ways of dealing with intraoperative zonular dialysis (ZD) and vitreous disturbance in suprahard cataracts. One was managed by phacoemulsification after stabilizing the capsular bag with capsular hooks and endocapsular rings; the other by converting to a nonphaco, self-sealing, small-incision cataract surgery. Both had anterior vitrectomy and PC-IOL implantation in the bag with gratifying postoperative results. The guiding surgical principles and crucial steps are elucidated. Basis for selection of the proper approach to nucleus removal, selection of appropriate surgical strategy, and adherence to intraoperative discipline in such challenging scenarios are highlighted.