Extracapsular cataract extraction with keyhole capsulorhexis and lens epithelial cell removal

Circular capsulorhexis with its round continuous anterior capsule opening allows secure fixation of a posterior chamber intraocular lens. The smooth capsular margin edge reduces stress concentration and the risk of radial tears but it makes nucleus delivery in planned extracapsular cataract extraction very difficult. This report describes a technique of small circular capsulorhexis with one relaxing incision that gives a keyhole-shaped capsular opening. A new irrigating capsule retractor for nucleus hydrodissection is also described. This technique is safe and highly reproducible and it allows secure posterior chamber lens fixation.