DR. SUDIPTA MITRA

, DR. SAGNIK SURYA DAS

Abstract

This was a case of a mature cataract deferred due to the pandemic in an 83 year old lady. The pupil would not dilate beyond 5.5mm. The capsule was decompressed after staining before rhexis but the rhexis was too small , around 4.5mm. we thought of extending it later. The cataract below the fluffy lens matter was hard and brown . Direct chopping failed to crack through and through as there was a leathery cataract and the pupil became further small and floppy. So we used 5 Iris hooks to expand the pupil . In the process of enlarging the rhexis with rhexis forceps, it extended to the periphery in 3 clock hours superiorly. But we managed to do multiplanar chop and with high vacuum, controlled fluidics and sharp chopper was able to make smaller pieces of the nucleus from periphery to center and emulsify it. Finally the central leathery part was also emulsified. After good irrigation aspiration, a single piece IOL was put in the bag and finally the case ended well .