In an eye with a truly dense, hyper-mature cataract, MSICS (manual small incision cataract surgery) can be a better option than phacoemulsification. While it will require a larger incision, there will be no ultrasonic energy to damage the corneal endothelium. In this case, MSICS was a great choice and the patient ends up with a beautiful outcome. There is also posterior capsule scarring which is treated primarily by performing a posterior capsulorhexis. Great learning in this case -- make sure you also learn this technique of MSICS.

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