• Spherophakia nightmare rescued by using all the right rules Description: Male patient presented to me with refractive corneal surgery in both eyes with residual high degree errors still present. By examination he did the right eye with by another surgeon with residual cataract, displaced IOL, contracted bag and with residual refraction of mixed high astigmatism. The left eye was cataracts with N+++ and normal posterior segment. UBM showed a typical picture of spherophakia which was not previously detected by the refractive surgeon and not put in mind with the surgeon who did the cataract in the right eye. I used all the best and rescue tools for the left eye to get the best results. I used FLACS to get the perfect size of the capsulorhexis, using the CTR to stretch the bag against the elastic zones then we succeeded to implant single piece inside the bag. I followed up the patient for centration and stable refraction with slit lamp photos showing this. Refraction was maintained by +0.25 Smh and - 0.75 astigmatism with UCVA of 20/20 in the left eye. So, Proper diagnosis of a cataract shperophakia case using FLACS and all the rescue tools can save the eye reaching the best results comparing to what happened in the right eye. Subspecialty: Cataract / Anterior Segment Level: Advanced Uploaded By: Ashraf Balamoun