Microincision cataract surgery is a new technique in the development of cataract surgery and is not without difficulties. Creation of the continuous curvilinear capsulorhexis as performed in conventional coaxial phacoemulsification surgery does not apply as readily. The authors describe a method for initiating the continuous curvilinear capsulorhexis (the laparotomy incision) using only an inexpensive 25-gauge bent needle cystototome. The technique involves a long linear incision in the anterior capsule down the belly of the lens as a means of initiating the capsulorhexis. Advantages of the technique include the creation of a large capsular flap, which allows easier completion of the continuous curvilinear capsulorhexis through a smaller range of movement, avoiding "oar locking" in the small incision and creation of striae in the cornea. It also allows better maintenance of anterior chamber depth, minimizing risk of radial tears.
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