Abstract
OBJECTIVE: To compare the microscopic and ultrastructural effects of capsulorhexis and diathermy capsulotomy on lens capsule. STUDY DESIGN: Anterior capsular specimens were taken at routine cataract surgery for light and electron microscopy. SETTING: Operating Theatre, Pathology Department, Manchester Royal Eye Hospital. PATIENTS: Four patients having diathermy capsulotomy and four capsulorhexis with no ocular pathology save cataract. MAIN OUTCOME MEASURES: Smoothness of capsule edges, presence of capsule splits and presence of lens epithelium adjacent to capsulotomy. CONCLUSIONS: Capsule edges were smooth and not swollen after capsulorhexis, with well-preserved lens epithelium. After diathermy capsulotomy capsule edges were swollen and contained longitudinal but no radial tears. After diathermy lens epithelium was less well preserved. In the absence of radial tears clinical impressions of a weaker capsulotomy after diathermy cannot be confirmed although tears might be found in the capsule that remains in the eye.
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