Using a Viscoelastic (also called Ophthalmic Visco-surgical Device, or OVD) to flatten the anterior lens capsule is a critical step in capsulorhexis creation. When the anterior chamber is relatively shallow and the anterior lens capsule takes its normal dome shape, the capsulorhexis will tend to run downhill and that means towards the zonular attachments. To facilitate capsulorhexis creation, we need to use our OVD to flatten the anterior lens capsule and deepen the anterior chamber. This will provide more working room and will give a planar capsular surface which will make the capsulorhexis creation easier since we can just move in a circumferential manner.
This is particularly important in smaller eyes where the anterior chamber is shallower. In rare cases we need to do special maneuvers like we have shown previously, but in most situations using a good viscoelastic is sufficient.
Click below to see this technique and a complete cataract surgery in a smaller eye:
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