Opening a collapsed, fibrosed capsular bag months after cataract extraction requires meticulous viscodissection and controlled fibrosis release. A dispersive viscoelastic is first injected to deepen the anterior chamber and gently separate anterior capsular leaflets. A sharp needle or micro-scissors can be used to create a small capsular opening, followed by careful enlargement with capsulorhexis forceps. Dense capsular fibrosis may require radial relaxing cuts to restore bag contour. Progressive viscoelastic injection helps reopen the bag and define the equator, allowing safe in-the-bag IOL implantation while minimizing zonular stress and posterior capsular rupture risk.
