This patient has a large anterior segment where the white-to-white diameter is almost 13 mm. He also has a large pupil of 6 mm in mesopic lighting conditions and enjoys being a -2 myope (spherical equivalent). For his cataract surgery we are using a toric monofocal IOL with a goal of leaving him -2.00 while addressing his corneal astigmatism. For the capsulorhexis in this case, I want to make it sufficiently large so that it gives him the full light transmittance of the IOL’s 6 mm optic even if the capsulorhexis hazes or whitens in the future. This means a capsulorhexis of at least 5.5 mm but less than 6.0 mm so that we can maintain the 360 degree overlap of the optic for accurate effective lens position.
