Pupil Woes

In this clinical video, Dr. Athiya Agarwal demonstrates how she managed a series of unfortunate events that occurred during complicated cataract surgery. Due to a small pupil, she inserts an I-Ring (Beaver-Visitec International), a polyurethane device that allows for a uniform 6.3-mm field of view. After starting surgery, the rhexis unexpectedly extends posteriorly, followed by a posterior capsular rupture that causes a nuclear fragment to drop into the vitreous cavity. After performing a vitrectomy, Dr. Agarwal encounters problems while externalizing the haptics of a 3-piece IOL. Finally, the I-Ring inadvertently causes an iridodialysis during removal, necessitating further repair before surgery is complete.