In cataract surgery we are taking out a 4 to 5 mm thick human crystalline lens and replacing it with a very thin manmade IOL. This means that in the post-op period the capsular bag will shrink-wrap and contract to securely hold the IOL. The capsulorhexis is important because it will help to hold the IOL in position and keep the optic planar and without tilt. Ensuring a consistent 360 degree overlap of the optic by the capsulorhexis gives a more predictable effective lens position and that means better refractive accuracy. You can certainly perform a beautiful capsulorhexis with forceps or a cystotome, but that certainly takes practice. It is one of the most challenging parts of the cataract surgery for newer surgeons. Other options include using a femtosecond laser to create the capsular opening, however the cost becomes the big barrier since these devices are very expensive. This video shows a routine case performed by me where I use the Zepto precision pulse system to create a consistent 5.2 mm diameter capsular opening which overlaps the optic beautifully. I encourage you to learn all different techniques and then decide which you prefer for your routine cases. This is a promoted video.
