Prof. Dr. Shalini Kumari

Abstract

Phacoemulsification surgery done for Morgagnian Cataract is one of the most risky surgery
Utmost care needs to be practised to achieve an uncomplicated outcome
The milky fluid, coming out while making a capsulorhexis, obscures the vision
The liquification of cortical matter leads to loss of support to anterior capsular flap
Key is to make a small rhexis and then, extend it into an adequate sized one with the help of vannus scissor and rhexis forcep
As the cortex surrounding the hard nucleus is liquified, doing a normal Stop & Chop or 4- Quadrant Nucleotomy is tough
The best technique is to do Direct Chop in supra-capsular zone which puts minimum stress on already weak zonules & posterior capsule
Burst mode should be put on in phaco-settings to emulsify & aspirate the hard nucleus
Insertion of IOL has to be gentle to avoid any complication, like zonular dialysis
Dreaded complications of Nucleus Drop, Posterior Capsular Rent & Zonular dialysis need to be avoided