This patient has severe capsular phimosis which happens where there is weak zonular support and aggressive contraction and fibrosis of the anterior lens capsule. This made the 5 mm diameter capsulorhexis shrink down to about 1.5 mm in diameter. We have covered this topic of capsular phimosis extensively before and you should know that the conditions which lead this include pseudoexfoliation and retinitis pigmentosa. This capsule will be tough to tear due to the fibrosis, so an alternate method such as micro-scissors, anterior vitrector, Zepto capsulotomy, or femtosecond laser capsular opening should be used. And our surgeon uses this last method. Great job and definitely worthy of a careful watch.
