White Cataract That Could Surprise Experienced Surgeon – Case Presentation

The aim of the study is to present a patient's case with cataract that surprised an experienced surgeon;

The surgical method of the nucleus removal, the possibility of visual acuity improvement, and postoperative healing process were presented,

Department of Ophthalmology, University Clinical Center of the Medical University of Silesia in Katowice

A 70-year old man, hospitalized because of high IOP in the right eye (RE) with advanced white cataract. RE distance BCVA was light perception. RE IOP was 29 mm Hg on maximal topical therapy

RE medical history: Uveitis in the course of toxoplasmosis more than 20 years ago, recurring every few years, Cataract progressing during observation, Not referred earlier for surgery due to retinal changes in the macular area caused by toxoplasmosis

Referred by the general ophthalmologist concerned about the "white pupil", looks like a white intumescent cataract. Pupil in almost circular synechiae, not responding to mydriatics

Surgery: after pupil dilation using iris hooks the situation change because of white pupillary membrane and dense subluxated cataract were presented.

Authors presented possibility and the course of surgery phacoemulsification, manual nucleus removal and  finalize with PPV.

Corneal edema occurred after the procedure,

In addition to standard postoperative treatment, endophthalmitis prophylaxis, intensive anti-edema and intensive corneal regeneration treatment were used.

Slow VA improvement was noticed, IOP stabilized 12-14 mmHg

Never give up on helping a patient, but assess your capabilities and take appropriate surgical decision.

It is important to know when to withdraw from the procedure if it is more beneficial for the patient.