This patient presents to our clinic with a lifelong history of bilateral posterior polar cataracts that have progressively worsened.
With the patient’s small pupils and the central lens opacity, the visual acuity has declined to 20/200. The patient is also highly hyperopic with a shallow anterior chamber, and the planned IOL power is +27 D for a goal of emmetropia.
All these factors make this a challenging cataract surgery, particularly the posterior polar opacity because this is associated with a high risk of posterior capsule rupture. The posterior capsule is weak, fragile and often