The classic teaching is to use a cystotome (a sharp, bent 25ga or 27ga needle) to puncture the anterior lens capsule and create a flap prior to using forceps to create the capsulorhexis. Instead, I prefer to just use the forceps to make the puncture into the lens capsule. I do this with the forceps open and then just puncture with one arm, then close the forceps. This ensures that I will certainly be grabbing the capsule the way that I want: one forceps arm on each side of it. Other surgeons prefer to do the entire capsulorhexis with just the cystotome. I encourage you to try the different techniques to determine which you like the best.
Click below to watch the video of capsulorhexis creation without a cystotome:
Hi Dr. Devgan, Will this technique work using any capsulorhexis forcep such as a utrata or must be it be one that has a sharp tip?
Any forceps will work — simply poke into the capsule with one arm and go.
Hello Doctor Devgan. Before we start this technique, is there any specific complication or difficulties related to it that we should be aware of ? Thanks a lot for all your videos