I used to think that the fewer grabs of the capsulorhexis, the better and I took pride in performing a capsulorhexis with just three grabs. While I can still do that, now I think it is better to go slower with more re-grasps, as many as needed, to make the capsulorhexis as perfect as possible. While it may not make a tangible difference in the refractive outcome of the case, it makes me happy and satisfies my perfectionist mindset. And since the signature that you leave on the eye consists of your incision and your capsulorhexis, let’s aim for the best. In this video, I show that it is perfectly fine to grab the capsule many times to achieve your goal. Also there is a helpful pearl about performing a capsulorhexis in a cortical cataract with poor visibility in the absence of Trypan Blue dye. While I use the Trypan Blue dye whenever it is truly needed, keep in mind that it is not totally benign. It can cause the capsule to become less elastic and more brittle and in the USA it typically costs between $66 and $100 for every single-dose syringe of 0.5 ml. For our CataractCoach fans in other countries, yes you are fortunate that it costs you less than $1 per use!
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