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    Pre-existing ruptured posterior capsule presents unique challenges

    Surgeons are urged to take a more cautious approach to cataract surgery when a new, pre-existing rupture of the posterior capsule surfaces.

    Surgeons are urged to take a more cautious approach to cataract surgery when a new, pre-existing rupture of the posterior capsule surfaces.

    For example, it is important to gently remove the nuclear material first while the cortex is still in place, said Gregory S.H. Ogawa, MD. The cortex can act as a scaffold, or splint, to help maintain support posteriorly.

    Dr. Ogawa, cornea and complex anterior segment specialist, Eye Associates of New Mexico, and assistant clinical professor of ophthalmology, University of New Mexico, Albuquerque, described the challenges associated with such a case.

    A retina specialist was treating a 56-year-old patient for a vitreous hemorrhage. After performing a pars plana vitrectomy and peeling scar tissue on the retina, the specialist prepared to cauterize a bleeding vessel. At that moment, the patient turned his head, causing the cautery probe to pierce the nasal portion of the lens. A cataract rapidly ensued, obscuring the view of the posterior segment.

    While some situations involving a posterior capsule rupture can be addressed weeks or months while the capsule begins to fibrose and to be less prone to splitting, the retina specialist in this case wanted to promptly view the posterior segment so cataract surgery could not be delayed.

    To watch Dr. Ogawa perform this procedure, click here to skip to the last page.

    Day 1 post-op exam

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