Aqueous misdirection and Expulsive haemorhage during routine cataract surgery Live Stream

Ophthalmic live  surgery.
WARNING:  The streamed content is real time surgical procedures which some viewers   may find disturbing and not appropriate . The content is intended for medical professionals , students, ophthalmic surgeons and not for general audience.
This case was rare combination of "aqueous misdirection " with consecutive expulsive haemorrhage. The eye is highly myopic , with advanced glaucoma , which can lead to "aqueous misdirection " during uneventful cataract surgery by fluid build up through zonules of zinn and accumulating it in posterior pole , thus inducing "malignant glaucoma strike " . The only management is vitrectomy to interrupt the "vicious circle " , which lowers the vitreal cavity volume and pressure. That in combination with BP above 200 led to consecutive Expulsive haemorrhage. The only thing that saved the eye was the immediate wound closure and maintained constant ocular pressure in combination with swift reaction of the Anaesthesiologist which lowered immediately the BP and provided consistent control of it for the next 12 hours