This is the double capsulorhexis technique which is a great choice for intumescent white cataracts. In these types of cases, the lens cortex has liquefied and then pressurized the capsular bag. This scenario where the intra-capsular pressure is higher than the anterior chamber pressure poses a high risk for uncontrolled capsular tear run-out, also called the Argentinian Flag Sign. Making the small initial capsulorhexis allows the surgeon to decompress the capsular bag and remove some of the liquefied cortex, after which time a larger 5 mm capsulorhexis can be created.
click to learn about the double capsulorhexis technique for intumescent white cataracts:
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