Viscosynechiolysis and Aspiration-Based Management in Uveitic Cataract Surgery: A Case Report

A 31-year-old female patient with a history of chronic uveitis presented with left eye decreased vision for the last two months. Examination revealed a left eye complicated cataract with dense posterior synechiae and poor pupillary dilation. Cataract is a common complication associated with chronic intraocular inflammation that develops with each uveitic episode. Surgical management of such a cataract is complicated by posterior synechiae, poor pupillary dilation, zonular weakness, and altered lens consistency. Conventional techniques may increase stress on intraocular structures and induce high postoperative inflammation. Viscosynechiolysis provides safe, controlled synechiae release with minimal iris trauma. In this case, recognition of the breadcrumb-like nucleus consistency allowed aspiration-based management, avoiding phacoemulsification energy and thereby reducing zonular stress. The intraoperative course was uneventful, and the patient had a stable postoperative recovery with a favourable visual outcome. This case highlights the importance of recognizing altered nuclear consistency in complicated uveitic cataracts and demonstrates that aspiration-based removal after viscosynechiolysis can be a safe and effective surgical strategy.