1. 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

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

3. 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

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

5. Frame grab: Broken titanium tip in the anterior chamber

6. 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

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

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