Making small capsulorhexis makes the cataract surgery more difficult because it limits access to the capsular bag and makes it tougher to bring nuclear pieces out of the capsular bag. When the capsular tissue opacifies with time, it can also restrict the effective pupil size and compromise night vision. And with an overly small capsulorhexis, the risk of complications can be higher as we explained in the video entitled The Curse of the Baby Rhexis.
There are some cases where a baby capsulorhexis is done at the beginning and then later enlarged prior to nucleus removal such as with intumescent white cataracts. We have explained that in detail here and here on CataractCoach where we called it the double rhexis technique.
In this routine case, there is no reason for a small capsulorhexis. You can see from the picture above that this is about a 4-mm capsulorhexis and that will make many parts of the surgery more challenging. Then at the end of the video, I show a solution to restore a normal capsulorhexis size.
Click below to learn about the perils of a baby capsulorhexis:
