1887: the challenge of the baby rhexis

You have heard me say it before, “don’t make a baby rhexis!” because for a novice surgeon, a small capsulorhexis makes the cataract removal more difficult. This video is from an expert surgeon who intentionally makes a small 4-mm diameter capsulorhexis to avoid the Argentinian flag sign. Vertical phaco chop is then used to break the nucleus into many smaller fragments which are then carefully extracted through this baby rhexis. At the end of the case this surgeon enlarges the capsulorhexis to a more appropriate size. I present this video so that novice and beginning surgeons can see just how much skill and dexterity it requires to operate through a baby rhexis. So if you have done fewer than 500 cataract surgeries, do yourself a favor and remember that CataractCoach says, “no baby rhexis!”

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