Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy

We present a technique, vitrectorhexis, in which a vitrector-cut capsulotomy is used to treat anterior capsule contraction syndrome. A vitrector handpiece is used to remove all fibrous capsule tissue and residual lens epithelial cells from the anterior chamber. Vitrectorhexis may be an alternative to neodymium:YAG laser capsulotomy as it decreases the risk of radial tear extension to the zonules and of secondary IOL decentration. The technique was used in a 77-year-old man with capsulorhexis contraction syndrome and extensive fibrosis after phacoemulsification with silicone piggyback intraocular lens implantation. One day postoperatively, visual acuity improved from 20/60 to 20/30 and the anterior chamber reaction was minimal. At 1 month, best corrected visual acuity was 20/20. The IOL was well centered at 6 months.