Comparison of 23 gauge and 25 gauge anterior capsulotomy forceps

In cataract surgery, the most commonly-used procedure for incision of the anterior capsule is continuous curvilinear capsulorrhexis (CCC), developed by Gimbel and Neuhann. As Gimbel has reported, CCC is a safe technique for phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. The optimum incision method for CCC is thought to be that of using anterior capsulotomy forceps. Recently, I have developed the side-port 23 gauge anterior capsulotomy forceps (23G forceps), manufactured by Asico, which can be manipulated via a small incision, as well as the side-port 25 gauge anterior capsulotomy forceps (25G forceps) and 25/23 gauge tapered anterior capsulotomy forceps (tapered forceps), manufactured by Inami, which are thought to provide even better ease of handling. In view of the fact that the visibility, ease of handling, bending, adverse effect on the wound, and effect on the cornea of these various forceps are important, the present comparison study among these forceps was conducted on pig lenses by means of 0.1 % trypan blue staining of the anterior capsule. It was found that capsulorrhexis was difficult with the 25G forceps because of the strong bend of the shaft. However, the tapered forceps has little bend, and like the 23G forceps, it showed outstanding handling and visibility and had little adverse effect on the wound.