New approach of tumbling and tilting technique in phacoemulsification for hypermature cataracts

Hypermature cataracts are characterized by a distended capsule and weakened zonules, increasing the risk of rupture and dialysis. The phacoemulsification procedure offers rapid recovery and excellent visual outcomes. However, while highly effective for most cataracts, it becomes challenging in advanced cases – particularly hypermature cataracts – even for the most experienced surgeons. This increases the risk of endothelial cell loss, thermal burns, corneal edema, and delayed postoperative recovery compared with standard phacoemulsification. The use of the tumbling and tilting technique in hypermature cataracts is uncommon, primarily due to existing guidelines and technical limitations. This report aims to describe the surgical procedure and provide a detailed account of its unique application in this case.