Radial extension of capsulorhexis in true exfoliation patient: a potentially hazardous complication

A 77-year-old woman presented with decreased visual acuity due to cataracts. True exfoliation of the lens capsule was detected in both eyes, and phacoemulsification cataract surgery with intraocular lens implantation was performed in the right eye. Before the continuous curvilinear capsulorhexis was started, indocyanine green dye was introduced into the anterior chamber; when the forceps was used during the capsulorhexis, the superficial layer of the lens capsule separated from the deep layer and induced an impending radial extension. We believe this is the first such case to be reported.