Dr.Sumitro Saha
Liquid cortex, weak zonules and often hard nucleus make cataract surgery in hypermature morgagnian cataracts a surgical challenge. Lens cortex in this 54-year-old patient was also absorbed, and together with weak zonules made the surgery more difficult. This video highlights the surgical challenges faced and steps taken to overcome the same. The 54-year-old gentleman had right divergent squint, vision of 1/60 , morgagnian cataract with absorbed cortex and phacodonesis. The surgery was performed under topical lignocaine anaesthesia. Anterior capsule was stained with trypan blue. Anterior chamber was filled with viscoelastic and anterior capsulorhexis initiated with bent 26G needle cystitome, in the capsular area overlying the nucleus. A small capsulorhexis was made. Weak zonules inferiorly was supported by capsular hook and capsular tension ring was implanted. Capsulorhexis was enlarged to deliver the nucleus into the anterior chamber. Nucleus was emulsified over an IOL scaffold.