By Surya Gupta, MD
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    In this video from Dr. Osher's Video Journal of Cataract and Refractive Surgery, Dr. Surya Gupta flounders through a case of hypermature cataract in which everything that could possibly go wrong indeed does.

    The surgeon chooses to perform phaco through an extended rhexis, which leads to a dropped nucleus. After a pars plana virectomy clears the nuclear fragments, the surgeon rashly proceeds with IOL implantation, but due to hypotony and poor placement, the lens drops when rotated. After a second vitrectomy, the IOL is retrieved and cataract surgery completed successfully. The patient returns, however, with sudden declining vision, and an inferior retinal detachment is confirmed.