Sinskey Hook-Guided Mechanical Peeling of Primary Posterior Capsular Plaque During Cataract Surgery

Primary posterior capsular plaque may be encountered during cataract surgery and can compromise the visual axis. Although Nd:YAG laser capsulotomy effectively treats postoperative posterior capsular opacification, it carries recognized risks, and intraoperative management may be preferable in selected cases. This report describes a simplified Sinskey hook-guided mechanical peeling technique performed before intraocular lens implantation. In a single adult case, plaque separation was achieved through controlled tangential glide-dissection beneath the plaque using a Sinskey hook, followed by forceps extraction. An ophthalmic viscosurgical device was used only for anterior chamber maintenance. The posterior capsule remained intact, allowing uncomplicated in-the-bag intraocular lens implantation. At three months, the visual axis remained clear without inflammation, intraocular pressure elevation, or need for Nd:YAG capsulotomy. This technique provides a simple, instrument-efficient intraoperative option for selected posterior capsular plaques.