Vectis

Then, again, the capsule may be insufficiently incised, or not opened at all. The surgeon generally discovers this failure when, on pressure, he finds that the lens moves slightly but makes no actual progress towards a complete exit. In that event, a very sharp cystotome should be used a second time. As mentioned before, the capsule of Morgagnian cataracts is extremely difficult to cut even with a proper capsulotome. Difficulty is to be expected with very opaque capsules, especially when they present a large, white, dense, circumscribed opaque area. Having been forewarned by these appearances the surgeon will employ a very sharp cystotome, using cautiously a little more force than usual, tearing the capsule if needed. Should vitreous escape in front of the lens and the latter sink backward into the vitreous the best plan is to finish the operation by means of a wire loop or vectis. This procedure does not necessarily increase the vitreous loss.