Femtosecond laser-assisted capsulotomy rescue for capsulorhexis enlargement

The anterior capsulorhexis is one of the difficult steps during cataract surgery. An anterior capsule opening that is too small can lead to capsule phimosis. We describe a technique for capsulotomy enlargement with the help of an image-guided femtosecond laser for cataract surgery. In 5 cases with a capsulorhexis diameter smaller than 4.0 mm, phacoemulsification and intraocular lens insertion were performed before the capsulotomy was enlarged. In all cases, it was possible to remove the additional capsule ring without complications. An anterior capsule tear did not occur in any case. The technique has potential for routine use in cases with a small anterior capsule opening.