Even if the pupil dilation is asymmetric, the capsulorhexis should be centered. This can be tricky if your normal routine … More
Tag: capsulorhexis
2009: ZeptoLink integrates automated capsulotomy
This is a tough case with a fibrotic anterior lens capsule in a patient who already had capsular complications (and … More
1991: zonular weakness during capsulorhexis
Look at the photo here and you just know that the zonular support is globally weak. There are radial wrinkles … More
1887: the challenge of the baby rhexis
You have heard me say it before, “don’t make a baby rhexis!” because for a novice surgeon, a small capsulorhexis … More
1830: trust yourself but question computers
I recently performed a cataract surgery case using a heads-up electronic display where the computer would overlay a precise circle … More
1785: centrally attached zonular fibers
This is an usual case where there are zonular fibers which are centrally attached onto the anterior lens capsule, so … More
1782: resident week: cystotome rhexis
The simple bent needle, also called a cystotome (or cystitome for the alternate spelling) can be used to create the … More
1765: keep the capsulorhexis centered
In this complete cataract case the pupil has dilated in an asymmetric manner. There is no history of trauma and … More
1687: ensuring capsular overlap of optic
In cataract surgery we are taking out a 4 to 5 mm thick human crystalline lens and replacing it with … More
1654: this capsulorhexis will radialize
Looking at this picture, the capsulorhexis appears to be proceeding well. It is round and intact and the resident is … More
1636: capsulorhexis challenges
This video features some challenges that I faced during capsulorhexis creation in seemingly routine cataract cases. Yes, even experts with … More
1609: Curriculum Lesson 7: Capsulorhexis
The capsulorhexis. One of my favorite parts of cataract surgery and one of the hardest steps to learn. When you … More
1579: phaco through small capsulorhexis
The double capsulorhexis technique is very useful for intumescent white cataracts because it allows us to safely decompress the capsular … More
1562: capsulorhexis considerations
As a beginning surgeon, the capsulorhexis is one of the hardest steps of cataract surgery to learn. The anterior capsule … More
1465: MSICS: bailout for rhexis runout
MSICS can be a great way to rescue a very difficult case. We recently presented a video of a master … More
1457: small capsulorhexis leads to trouble
This is another case where the capsulorhexis is about 4 mm in diameter and this causes a complication where the … More
1456: operating through a small rhexis
Keep in mind the dimensions of the typical cataractous lens: about 9-10 mm in diameter and then about 4-5 mm … More
1444: the patient moved during the rhexis
As I am performing the capsulorhexis, the patient unexpectedly moved and there is a run-out of the capsule tear. The … More
1420: cystotome capsulorhexis
Beginning residents are amazed when they see that a complete capsulorhexis can be completed with just a cystotome. Using just … More
1418: advantages of Zepto capsulotomy
There are many ways of performing the steps of cataract surgery. We can do the capsulorhexis / capsulotomy with a … More
1414: white cataract, small capsulorhexis
A small capsulorhexis can pose a big challenge during cataract surgery. Keep in mind that a typical human cataractous crystalline … More
1400: handling the run-out capsulorhexis
The capsulorhexis has a tendency to run-out if the anterior lens capsule is insufficiently flattened, if there is any posterior … More
1387: Zepto Precision Pulse Capsulotomy
The Zepto device uses a brief pulse of electricity to instantly create a precision capsulotomy in the anterior lens capsule. … More
1362: keratome to start the capsulorhexis
Our guest surgeon has an interesting technique where he uses the keratome to start the capsulorhexis. This saves a step … More
1345: capsulorhexis split – now what?
This patient has a white cataract and this resident is able to perform a successful capsulorhexis after staining with trypan … More
1340: plan your rhexis to avoid opacities
Yesterday’s video (#1339) showed how to move cortical opacities from the path of the capsulorhexis by pushing the liquefied lens … More
1339: you can move cortical spokes
Cortical lens opacities tend to block the red reflex which can make capsulorhexis creation more difficult. Since these cortical spokes … More
1322: femtosecond laser or forceps?
Look carefully at this title photo and tell me which eye had a capsulorhexis with forceps and which eye had … More
1310: why the capsulorhexis matters
The capsulorhexis is a critical step of cataract surgery for two main reasons: it creates a stable and strong opening … More
1294: capsulorhexis in a 5 year old child
The lens capsule changes in elasticity over our lives: it is far more elastic in youth than it is in … More
1255: does rhexis morphology matter?
Does the shape of the capsulorhexis matter? We are accustomed to making a 5 to 5.5 diameter capsulorhexis that is … More
1220: white cataract phaco puncture
This is a resident case of an intumescent white cataract. We have covered this topic many times and the theme … More
1205: how to perfect your capsulorhexis
The capsulorhexis is crucial in cataract surgery because it gives capsular integrity during nucleus and cortex removal and also provides … More
1186: Capsulorhexis danger zones
When I participate in a meeting, I always learn much more than I teach. I recently gave a graduation lecture … More
1172: anterior capsular tear in phaco
The lens capsular bag is fragile and very thin, with an anterior measurement of about 14 microns and a posterior … More
1132: Playlist: white cataract capsulorhexis
Performing a successful capsulorhexis is one of the biggest challenges in eyes with white cataracts, particularly intumescent white cataracts. This … More
1122: Remote Capsulorhexis Training
Prof. John Ferris has started a novel program of remotely teaching young surgeons to improve their surgical skills. This can … More
1120: make sure the IOL is centered
We want the IOL optic and the capsulorhexis to both be centered. This is especially important for multifocal IOLs and … More
Playlist: Capsulorhexis
The capsulorhexis is an important step of cataract surgery. It allows us to maintain the strength of the capsular bag … More
measure the capsulorhexis in high myopia
Eyes come in a spectrum of sizes, particularly with the measurements of the anterior segment in patients with extreme refractive … More
Capsulorhexis Pearls
By watching many surgeons, we can learn different ways of performing the same procedure. In this case, Dr Luis Escaf … More
Cataract Quiz: Use the can-opener now?
During capsulorhexis creation, this resident surgeon loses control of the anterior capsule edge and it runs all the way out … More
Spiral Capsulorhexis Technique
After needle decompression of the cataract, using a spiral technique for the capsulorhexis has a distinct advantage: if there is … More
Wrinkled and fibrotic lens capsule
This seemed like a typical white cataract during the pre-operative exam and when first placed under the surgical microscope on … More
Cataract Quiz: Argentinian Flag Sign
Cataract Quiz: How can you prevent the dreaded Argentinian flag sign now? White cataracts can pose a challenge when performing … More
Enlarge the Capsulorhexis
A small capsulorhexis makes nucleus removal more difficult, especially when we have a dense cataract. When the entire lens hardens … More
Do not make a baby capsulorhexis
Making small capsulorhexis makes the cataract surgery more difficult because it limits access to the capsular bag and makes it … More