The capsulorhexis is a very important part of the cataract surgery because it ensures compartmentalization of the eye during phacoemulsification and gives us a secure place to implant the IOL. If there is just one small area of capsulorhexis run-out, that is enough to cause significant complications such as a posterior capsule rent, vitreous prolapse, and more. This is what happened in this case and it could very well happen to you as well. This video shows how the complication happened and then how the case was successfully rescued. There is so much to be learned from this video.
click to learn how to manage the vitreous prolapse after a run-out rhexis:
Dr. Devgan – I’ve watched many of your videos and after watching this one in particular, I would point out an alternative to the rhexis technique you teach. I perform mine starting about 2 clock hours to the RIGHT of the main incision (versus yours to the left). The capsulorrhexis is well established by the time I get to the danger zone and less likely to radialize.
Thanks for the great work. Even though I’ve been doing cat surgery since the extracap days, I’ve learned a great deal from these videos.
Good point. Thanks for sharing it with our readers/viewers.
What about restarting the rhexis in the other direction (clockwise configuration)? You may have gotten lucky and incorporated the area of tear out into the rhexis. When you make a incision in your initial flap, there is no way to incorporate that area of weakness.