Arab Board Ophthalmology Clinical & Oral Practice Questions - Arab Board Ophthalmology Final Clinical And Oral Examination (ABHS) Exam

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During quadrant removal in a routine cataract surgery, the posterior capsule ruptures with vitreous presenting into the anterior chamber. The nuclear fragment is still present in the anterior chamber. What is the most appropriate immediate sequence of surgical actions?

Immediately pull the phaco tip out of the eye and insert an anterior vitrectomy cutter Lower the infusion bottle, inject a dispersive ophthalmic viscosurgical device (OVD) under the nuclear fragment, and withdraw the phaco tip under viscoelastic control Raise the infusion bottle to maintain anterior chamber depth and accelerate phacoemulsification of the remaining fragment Perform high-vacuum automated aspiration to clear the vitreous before addressing the lens fragment

Correct Answer:

Lower the infusion bottle, inject a dispersive ophthalmic viscosurgical device (OVD) under the nuclear fragment, and withdraw the phaco tip under viscoelastic control

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