To perform the Little rescue technique for a run-out capsulorhexis, the surgeon must first flatten the anterior chamber by removing some ophthalmic viscosurgical device (OVD) or by making the chamber shallower. The key maneuver involves using capsulorhexis forceps to grasp the leading edge of the tear. Instead of continuing the circle, the flap is pulled backward, directly toward the center of the lens, while simultaneously pulling it in the opposite direction of the tear’s radial path. By pulling the flap centrally and toward the completed portion of the rhexis, the surgeon creates a vector of force that redirects the tear back toward the desired circular path. This redirection relies on the elasticity of the capsule and the specific tension created by the rescue maneuver. Once the tear is redirected centrally, the surgeon can then resume the normal curvilinear path to complete the capsulotomy safely. This prevents the tear from extending toward the zonules or the posterior capsule.
