Routine case, but what’s this line on the capsule?

line on capsule 177 title

This is a perfectly routine cataract case and it goes beautifully. But then, at the end of the case with the IOL nicely positioned in the capsular bag, you notice a line on the posterior capsule. What should you do? Leave it alone? Try to fix it?

It can be a tough call, depending on the cause of the line. It could be:

  • damage to the IOL from the inserter
  • a fold in the posterior capsule (from loose zonules and capsular bag laxity)
  • a small break in the posterior capsule
  • residual strand of cortex
  • lint or other retained foreign body

The reveal is at 4:45 in case you’re too busy to watch a 5 min surgery.

What would you do? Click below to watch the video to see what I did:


  1. Wonderful. I think rotating the IOL in the bag is more easy clock wise rather than anti-clockwise!You rotated it clockwise.
    Your comments Dr Devgan

      1. it depends when the haptics unfold. While the haptics are still folded, the IOL is easily rotated in either direction.

        Once the haptics are unfolded, it is easier to rotate clockwise. If counter-clockwise is attempted, the open haptics tend to grab the capsular equator

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