1172: anterior capsular tear in phaco

The lens capsular bag is fragile and very thin, with an anterior measurement of about 14 microns and a posterior capsule as thin as 4 microns. A single red blood cell is about 7.5 microns in diameter for comparison and a human hair is about 75 microns thick. In this case we started with a great capsulorhexis that is round, intact, and well centered. However, once the nucleus was removed, we noted that there was a tear in the anterior capsular rim. How can we safely complete the case and give the patient an excellent visual outcome? Keep in mind that this patient is getting a toric trifocal IOL which must be placed in the capsular bag, at the correct meridian and centered with the visual axis, without causing this capsular tear to extend to the posterior capsule. This is a challenge — let me show you how to successfully overcome it.

click to learn how to complete this case given the challenges of an anterior capsular tear: