Management of The Argentinian Flag Sign in Open-Sky Cataract
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We present a case in which the Argentinian flag sign occurred in a patient who had combined keratoplasty and open-sky cataract extraction for acute perforated hydrops. The patient had advanced keratoconus and an intumescent cataract. The complication was managed using an open-sky approach rather than a closed anterior chamber approach. Although capsule tears are more likely to occur in open-sky conditions because there are no forces against the pressure in the capsular bag, our technique followed the principles of a closed anterior chamber technique and avoided maneuvers that could extend the tears posteriorly. An intraocular lens was safely implanted in the bag with the haptics placed perpendicular to the capsule tears.

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