In this video, which was anonymously submitted, an experienced surgeon encounters a routine cataract case where the anterior capsule is found to be radialized towards the zonular attachments. How do you deal with this case now? How can you prevent this tear out from extending to the lens equator and even to the posterior capsule? Can you still implant the IOL in the capsular bag? Now what?
Click below to learn how to deal with a radialized anterior capsule:
Could it be possible that the phaco tip hit the anterior capsule when emulsifying the first half of nucleus? Because capsular opening is somewhat smaller at the subincisional meridian.
That’s a great thought and certainly a strong possibility. Thanks for your keen observation.
It seems that orienting the haptics at 90 degrees to the anterior capsular tear would cause more stress on the tear and increase the chances of posterior extension. In the couple of dozen or so cases I’ve had over the years, orienting the haptics along the axis of the radial tear has not caused any issues. Thoughts? Thank you for all your teachings!
Ultimately, any placement which gives long term stability is fine.