"THE IMPOSSIBLE CATARACT: USING THE RETINA TO HELP OPERATE ON THE CATARACT."

The video presents a complex procedure aimed at extracting a dense cataract in a patient with an opaque cornea, which makes visualization of the anterior segment extremely limited.

The technical challenges are significant: the corneal opacity prevents normal illumination and visualization of the intraocular structures, making the phacoemulsification procedure risky without additional optical assistance.

To overcome this obstacle, it was decided to use endoillumination from vitreoretinal surgery. A light probe is introduced into the vitreous cavity, diffusing internal light that illuminates the anterior segment structures from within, making the lens capsule and surgical instruments visible.

Other approaches can also be considered in this type of situation, such as the use of transscleral illumination or keratoplasty.
However, these methods have their own limitations, particularly in terms of complexity, cost, and surgical risk, which makes endoillumination a simple, effective, and minimally invasive alternative.

Thanks to this technique, the capsulorhexis (opening of the anterior capsule) is performed with precision, followed by nucleus emulsification and intraocular lens implantation.