3063: review of the capsulorhexis rescue
Mastering the Little capsulorhexis rescue maneuver is an absolute necessity for every cataract surgeon when an anterior capsular tear begins to extend radially toward the zonules and equator. When vector forces drive the tear outward, continuing simple shearing force will only cause a catastrophic wrap-around tear into the posterior capsule. The key to the Little maneuver lies in immediate flattening of the anterior capsule with additional heavy cohesive or viscoadaptive viscoelastic (OVD), followed by grasping the capsular flap near its apex and pulling directly backward along the origin of the tear, in the opposite direction of the tear’s trajectory, while applying flat, tangential vector force to redirection the tear back toward the center.
Watch the video to analyze the exact vector mechanics and hand positioning required to execute the Little maneuver and save an escaping capsulorhexis. What are your go-to pearls for regaining control when an anterior capsule tear threatens to extend to the periphery? Please comment your thoughts below.
