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    Impossible Capsulotomy

    By Dr. Suven Bhattacharjee
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    Dr. Suven Bhattacharjee shares a challenging anterior capsulotomy in a patient with a hypermature cataract. After many attempts to advance the capsulorhexis, he resorted to “nibbling” at the anterior capsule. The result was a small, eccentric capsulorhexis of an indescribable shape. Remarkably, there was no extension of any of these nibbled notches along the capsulorhexis margin, even under considerable stretching of the capsulorhexis margin during IOL implantation. He believes that while making the capsulorhexis was difficult, it also had a protective effect on the capsulorhexis margin.