Anterior Capsular Tear During Phacoemulsification: Successful Management With the Two-Y Crushing Technique

An anterior capsular tear or radial extension of the capsulorhexis is a serious complication during phacoemulsification and may lead to significant sequelae. In the present case, an anterior capsular tear occurred during capsulorhexis in phacoemulsification surgery. We opted to use the Two-Y crushing technique to safely emulsify and aspirate the nucleus in the presence of an anterior capsular tear. This technique was originally described for nuclear cracking in posterior polar cataracts (PPCs) under the protection of an epinuclear shell, with the advantage of minimizing capsular stress. In this technique, following successful hydrodelineation and viscodelineation, the nucleus was prolapsed out of the capsular bag, crushed into multiple fragments using two Y-rotators, and subsequently emulsified using a phaco probe in the anterior chamber at the iris plane. Throughout the procedure, minimal stress was exerted on the torn anterior capsule, and with appropriate precautions, the surgery was completed successfully with a favorable visual outcome.