The lens capsule changes in elasticity over our lives: it is far more elastic in youth than it is in middle or old age. This case shows a capsulorhexis being performed in a 5 year old child where the capsule is very elastic. The technique is excellent and most of the capsule tearing is done via a paracentesis using a bent needle in order to keep the anterior chamber pressurized to flatten the lens capsule. Trypan blue dye is also used since it makes the capsule less elastic in addition to staining it. For cataract surgery in babies (infant lensectomy), even this technique may not work well and the two-incision push-pull technique from Ken Nischal MD offers more control.
click to learn about the challenges of performing a capsulorhexis in a young child: