Video Presentation - VT23

Victory to Chaos: Final-Step Surprises in Cataract Surgery

Study Design:Surgical video. Purpose: To demonstrate how excessive side-port hydration at the end of cataract surgery can result in unexpected complications and highlight preventive strategies. Methods: Two intraoperative cases are presented. The first demonstrates posterior capsular rupture with intraocular lens expulsion following over-hydration of an already formed anterior chamber. The second shows epibubble formation after continued hydration despite an adequately formed chamber. Slow-motion video analysis correlates the maneuvers with the resulting complications and highlights early warning signs. Results: Both complications occurred during the final step of otherwise uneventful surgeries. Excess hydration caused sudden pressure-related complications despite adequate chamber formation. Conclusion: Side-port hydration is a critical step requiring restraint rather than force. Recognizing warning signs and stopping hydration at the right moment helps prevent avoidable complications.