Fracture of the phaco tip during Micro Incision Cataract Surgery Dr. Ramesh Dorairajan Dr. Geetha. P. Dr. Devi R. Sundar eye hospital. Chennai. India There is no financial interest in this presentation

Objective To demonstrate an unique complication of micro incision cataract surgery First case report of breakage of a 800 micron titanium tip during MICS

MICS was performed for a hard nuclear cataract by the peripheral chop technique. An angled 800 micron titanium phaco tip was used The phaco tip fractured into two pieces inside the anterior chamber during the procedure

Frame grab: Titanium tip fractures while separating the chopped fragments Broken tip

Frame grab: Broken titanium tip in the anterior chamber

The incision was enlarged to 2 The incision was enlarged to 2.8 mm The tip was removed by the railroad technique. Uneventful standard phacoemulsification was performed

Frame grab: Railroad technique to remove the distal tip Incision was enlarged to deliver the fragment 28 G needle inside the broken tip

conclusion Thin walled angled MICS tips may have to be used with caution in certain types of cataracts.