A baby rhexis can cause a cascade of problems. See what could have been improved in this posterior capsule rupture and visit Dr. Devgan’s cataract coach site here to read a more in-depth analysis.
1) Avoid a baby rhexis! The rhexis should be 5 to 5.5mm in size which will facilitate an easier surgery and still allow the edges to overlap the 6mm optic.
2) Be careful grooving with the phaco near the edges of the lens. It’s easy to go too far and punch a hole in the posterior capsule.
3) When there is any posterior capsule rupture, instill viscoelastic into the anterior chamber prior to coming out of the eye with your instruments. This will prevent anterior vitreous prolapse and keep the anterior hyaloid membrane intact.
4) If the integrity of the posterior capsule is in question, don’t hesitate to switch to a 3-piece sulcus lens.