Intracapsular lens delivery during attempted extracapsular cataract extraction. Association with capsulorrhexis

Continuous circular tear capsulotomy, or capsulorrhexis, has become a popular technique in cataract extraction, especially in phacoemulsification. The authors report on six cases from five different surgeons at three institutions, in which the entire lens was inadvertently delivered on attempted expression of the nucleus after circular capsulorrhexis. In one case, scanning electron microscopy suggests that the smooth edge of a small, closed, capsular tear is not capable of controlled extension to allow nuclear egress. Therefore, superior radial anterior capsular relaxing incision is recommended when circular capsulorrhexis is used in extracapsular cataract extraction.