Posterior polars poses a unique challenge during cataract surgery with pre-existing dehiscent posterior capsules. The aim here is to protect the posterior capsule, increase the option of implanting advanced technology IOLs like toric and multifocal, as the incidence of PC rupture can be as high as 26% to 36% of patients. There could be tight adhesion between the posterior capsule and the cortex wherein changes in nucleotomy techniques and fluidics is needed to minimise the torsional or tractional stress on the PC. These videos demonstrate different nucleotomy techniques – inside out hydrodelineation, zero energy phaco, etc. and also the appropriate phacodynamics settings which would minimise the incidence of opening of PC leading to vitreous loss and a second procedure. This is achieved by actively interacting with the phacodynamicsparameters like IOP, vacuum, IOP ramp and AFR. And active fluidics has helped improve the outcome.
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