The two techniques shown in this video have not been previously featured on CataractCoach and since they are from the same surgeon, I put them together in this same clip. The first is using scissors to perform multiple small sphincterotomies of the iris margin to help with pupil expansion. It works well but there is the issue of a cosmetic defect. This is not critical to most patients but there are some patients, particularly in my practice where we treat many Hollywood actors, who cannot tolerate the iatrogenic pupil irregularity.
The second technique is something that I’ve not seen before. Using a sharp blade to create two openings in the anterior lens capsule of a lens with very poor zonular support. Then a blunt cannula is placed through these two openings much like placing your hand through a bag handle. This allows fixation of the capsule while the capsulorhexis is created.