By Dr. Arup Bhaumik
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    Dr. Arup Bhaumik shows how he managed a torn posterior capsule in a patient with a hypermature cataract. After de-bulking the nucleus and employing the divide and conquer technique, the second fragment becomes unstable during emulsification and threatens to sink into the vitreous. He begins by stopping irrigation and stabilizing the fragment with the chopper. He removes the phaco probe, further stabilizes the fragment with viscoelastic and coaxes it above the iris. A 3-piece foldable IOL is implanted in the sulcus and optic capture is done. The remaining fragment is emulsified with normal phaco parameters and the optic capture released. Dry aspiration is used to remove cortical material and vitreous face.  A vitrectomy is performed and the remaining cortex removed. Optic capture is done again and the procedure closes with a triamcinolone-assisted vitrectomy.