More Than One Way to Skin a Cat(aract)

In this surgical video, the author demonstrates a cataract extraction in a middle-aged patient with proliferative diabetic retinopathy, history of tractional retinal detachment, and long-term silicone oil in the posterior segment. Multiple methods are presented for incising the anterior lens capsule to initiate a capsulorhexis in the context of a mature white cataract and dense fibrotic capsular plaque. In addition, a scenario is presented in which conversion to small incision extracapsular cataract extraction is prudent to avoid surgical complications.