We describe a method to enlarge an initial small capsulorhexis using an iris spatula and cystotome needle. The iris spatula is placed underneath the anterior capsulorhexis margin; the spatula supports the anterior capsule and protects the posterior capsule. A gentle touch on the spatula by the cystotome needle generates a break in the continuity. This is done prior to intraocular lens implantation with the capsular bag and anterior chamber filled with viscoelastic.
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Vasavada et al. (1997) studied this question.
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