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When a cataract looks like a dinosaur egg: case report

Poster Details

First Author: A.Brito PORTUGAL

Co Author(s):    C. Bacalhau   P. Neves   M. Ornelas   D. Martins     

Abstract Details


To report an unusual case of a complicated cataract surgery in a slightly subluxated cataract that had a very hard and harsh involucre.


Department of Ophthalmology, Hospital de Setúbal, Portugal


A 62-year-old woman presented with a mature white cataract slightly subluxated superiorly on her right eye. This eye had no light perception since 2010 because of severe diabetic retinopathy and the patient wanted the surgery for aesthetic purpose. The patient was proposed for cataract phacoemulsification without an IOL implantation. Surgery was digitally recorded and photographed.


On the beginning of the procedure, capsulorhexis was impossible to perform because the capsular sac and lens cortex were fused. We decided to break the cataract using horizontal chop and then collect the two heminucleous with a kansas lens loop. However, when we used the chop technique the cataract completely detached (luxated). We had to perform 23-gauge vitrectomy and extracted some of the largest fragments from the posterior segment through the corneal incision. In the end of the procedure, eye was filled with balanced salt solution and the 2.75 mm corneal incision was sutured. The postoperative period progressed without complications.


This case demonstrates that phacoemulsification can not always be the most recommended procedure to perform, and in rare cases there still might be a place for intracapsular cataract extraction. FINANCIAL INTEREST: NONE

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