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Case surgery of a hard intumescent cataract, performed MSICS technique, without using viscoelastic and instead I use an anterior chamber maintainer.
During surgery I presented capsulorhexis tear out, I completed the capsulorhexis from the other side and performed MSICS to remove the whole nucleus, a Simcoe cannula is used to remove the cortex and then a PMMA IOL is successfully implanted.

