Capsulorrhexis Size
Making a capsulorrhexis diameter smaller than 5 to 6 mm prevents dislocation of the IOL from the capsular bag into anterior chamber, and often eliminates the need for postoperative pupillary constriction. However, if pupillary constriction is needed after lens implantation, intracameral carbachol may be preferable to acetylcholine, because the former has been associated with better early postoperative pressure control (84).
In another study, a combination of intraoperative acetylcholine and postoperative acetazolamide was more effective in preventing an acute IOP rise than either medication alone (85). It has been reported that a flap of anterior lens capsule can be included in the trabeculectomy site to facilitate filtration in combined trabeculectomy with ECCE and posterior chamber IOL implantation (86).
