The Rhexis Size Conundrum

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2 min read

Dr. Wörtz reviews how to use a capsulorhexis marker to accurately identify rhexis size when performing a capsulotomy.

At least once in their career, even the most adept cataract surgeons have likely made the capsulotomy slightly too large for the lens. With eyes having varied iris and pupil sizes, it is easy to misgauge the size of the rhexis.
Though utilizing a femtosecond laser will ensure a consistently centered capsulotomy, determining the precise size of the incision can still be challenging.

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The benefits of using a capsulorhexis marker

In my practice, I have adopted a tool that can simplify and add predictability to the process: the Kellen CCC Marker 5.5mm from Corza Ophthalmology, a business unit of Corza Medical (formerly Katena Instruments). The Kellen CCC Marker consists of a marking ring with four non-marking alignment pegs and is constructed from stainless steel for durability. The marker is similar to a cookie cutter in that it makes a circular impression on the epithelium to serve as a guide.
By tracing this mark, you can gain consistency in the circularity and size of the capsulotomy. In my professional opinion, this can provide a superior incision to place the intraocular lens (IOL) compared to other techniques to achieve an optimal 360° overlap. During the procedure, by using Utrata capsulorhexis forceps with one hand and holding the globe central with the other, I can achieve minimal parallax error.

Note: Though BSS Plus Sterile Irrigating Solution makes it slightly more difficult to see the epithelial impression made by the Kellen marker, it is still visible enough to work with during surgery.

Final thoughts

One of the tracks we leave as surgeons is the size and shape of the capsulotomy. With the Kellen CCC Marker 5.5mm, it has given me the confidence to create a consistent circle that meets my expectations every time, which can guarantee a precision capsulotomy and proper IOL placement, regardless of the size of the eye.
The functionality and predictability of this marker have made it an indispensable tool in my operating room.

Disclaimer: The Kellen CCC Marker 5.5mm from Corza Ophthalmology, a business unit of Corza Medical (formerly Katena Instruments), is meant to serve as an adjunct tool to assist physicians in impressing a circular pattern on the cornea to serve as a guide for performing a 5.5 to 6mm diameter capsulorhexis. The medical opinions and views expressed in this article are those of Gary Wörtz, MD.

Gary Wörtz, MD
About Gary Wörtz, MD

Gary Wörtz, MD is a board-certified ophthalmologist from Lexington, KY specializing in cataract and refractive surgery.

Since completing his training in 2008, Dr. Wörtz has successfully performed thousands of cataract and laser procedures. He currently practices in Lexington at Commonwealth Eye Surgery. Dr. Wörtz became one of the first surgeons in Kentucky to perform laser refractive cataract surgery. He utilizes the latest technology both in and out of the operating room to help restore vision for cataract patients.

Dr. Wörtz enjoys innovation and teaching his techniques to others around the country. He has been a consulting speaker for Alcon, AMO, Bio-Tissue, TearLab, Carl Zeiss Meditech and Dialogue Medical. He has also been a principal investigator in multiple FDA pharmaceutical trials in the ophthalmic sector. He has given numerous lectures at both the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgeons annual meetings. He is also a frequent contributor to many trade journals such Cataract and Refractive Surgery Today, MillennialEye, Ophthalmology Times, and EyeWorld, and was recently named to the editorial board of Ocular Surgery News.

Gary Wörtz, MD
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