Dr.Deepak Megur, Dr.Bharathi Megur
Capsulorrhexis is challenging in complex cases like fibrotic and calcified anterior capsules commonly seen in traumatic cataracts, hypermature cataracts and in eyes with loose zonules.These fibrotic capsules are difficult to tear and will impart more stress on the zonules while tearing and have increased risk of peripheral extension.We demonstrate a technique of using the vitreous cutter to perform capsulotomy in such cases.The vitreous cutter at moderate cut rates and low vacuum is used to cut the capsular margins in the area having calcification and fibrosis.This technique helps to cut the capsule without imparting any zonular stress. High magnification photographs reveal the cut edges to have curved margins with concavity towards the centre which is unlike the can opener technique of capsulotomy.The vitreous cutter assisted capsulotomy margins demonstrated reasonable strength to withstand moderate stress forces encountered during phaco manoeuvres and CTR insertions.