In this video, a run-out of the capsulorhexis towards the pupil margin starts temporally. The resident is able to rescue the rhexis with a good end result.
1. Use the tip of the forceps to trace out the circle for the capsulorhexis. Read about this more on Dr. Devgan’s cataract coach site here.
2. Once you see a run-out starting, the Little maneuver is an effective way to rescue the rhexis.
3. The most important aspect of managing this run-out is to keep the rhexis continuous in a 360 degree circle. As long as the rhexis is continuous and intact, it is able to maintain its strength during nucleus removal.
4. If there is an irregular rhexis, orient the haptics of the IOL AWAY from the irregularity.
Excellent job by the resident and tips by Dr. Devgan.
Extra tips: Add extraviscoelastic once you start to see things running out.
Thanks for the comment, that’s a great extra tip!