Ophthalmologists in the developing world often encounter hypermature white cataracts. These cases present various problems during surgery, such as elevated endocapsular pressure, poor visualization of the anterior capsule, inability to view the posterior capsule, and difficulty creating a capsulorhexis. In many of these cases, after the cataract is successfully removed, surgeons come across opacities of varying intensity and locations on the posterior lens capsule. The surgeon must then decide whether to do a primary posterior capsulorhexis during the surgery or plan for a neodymium:YAG (Nd:YAG) capsulotomy at a later time.
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