We have shown previous cases of posterior capsulorhexis here and here and in both this was performed prior to IOL insertion. Also both cases were performed by my UCLA ophthalmology residents during their senior year of training. Certainly, any cataract surgeon in practice can also learn and succeed with this technique. There is, however, an alternative technique which may provide a wider margin for safety by performing the posterior capsulorhexis behind the optic of the IOL which is already in the capsular bag. The optic will act as a barrier to help prevent any vitreous prolapse and it reduces the risk of a complication during IOL insertion. Our guest surgeon, Dr Luis Escaf from Colombia, does a beautiful job with this technique.
click to learn to perform a posterior capsulorhexis behind the IOL optic: