Management of posteriorly dislocated nucleus depends on the density of the cataract. relatively soft nuclei can be managed in situ, however dense nuclei need floatation into the anterior chamber, then either an anterior chamber phaco fragmentation is performed or the nucleus is delivered via a cornel/ corneoscleral wound. I present 2 cases: Case 1: Average density nuclear fragment. i performed a Bimanual mechanical manipulation and fragmentation of the nuclear fragment using a 23G vitreous cutter probe and a 23G fashioned Pick. the nuclear material was completely engulfed without any retinal tears or hemorrhage.

I performed the same Bimanual Approach. The nucleus was fragmented with extreme difficulty, abd there was massive retinal breaks and retinal hemorrhage. I had to inject silicone oil at the end of the procedure and to postpone secondary posterior Iris claw lens implantation for a second surgery after silicone oil removal. mistake: I imposed my tools and technique on the procedure.

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