Cataract surgery (phacoemulsification) in difficult cases

By presenting three cataract surgeries, we discuss the difficulties of the interventions and the key moments. Case I: Mature cataract surgery on a patient with corneal opacities (maculas). Case II: Posterior polar cataract. Case III: Small pupil, shallow anterior chamber (dilating with Malyugin ring).

The surgery of a mature cataract on an eye with corneal opacities can be performed by a surgeon with enough experience. The final visual acuity depends on the clarity of the center of the cornea. During the operation of a posterior polar cataract we have to be prepared to the rupture of the posterior capsule, which is more frequent than in other cases. These interventions are better to be made in centers with posterior pole surgery capabilities. The Malyugin ring is a novel PMMA device, which dilates the pupil, creating decent conditions for a cataract surgery This device can be inserted and pulled out through a standard 2,8 mm incision.