Breaking More Than Synechiae
This cataract surgery was complicated by central posterior synechiae from the iris to the anterior lens capsule and a small pupil overlying a very dense nucleus. Unfortunately the lysis of the synechiae with hooks resulted in a tear of the anterior capsule. Unfortunately, during the initial phaco even without hydrodissection the lens was loose. We converted to Extra Capsular Cataract Extraction which would have been very difficult with a Malyugin ring in place but was relatively easy with hooks.
Additional Notes: length 7:44
reference: Dupps WJ, Oetting TA, Diamond iris retractor configuration for small-pupil extracapsular or intracapsular cataract surgery, J Cataract Refract Surg. 2004;30(12):2473-5.