Mechanism of radial tear formation and extension after anterior capsulectomy

The mechanisms of anterior capsular radial tear formation and extension around the equator onto the posterior capsule were investigated in 57 eyes obtained postmortem. Experimental radial tears were created by gradual opening of a caliper. In 95% of cases, the tear immediately reached the equator but none extended to the posterior capsule. The elastic forces of the zonules attached to or crossing the edges of the tear resisted a widening of the gap between the edges and thus limited the radial progression of the rupture. A significantly stronger force and severing of the zonules were necessary for a tear to extend around the equator. The authors have determined that radial tears in the anterior capsule seldom extend around the equator, providing the zonules bridging the tear are intact. There is a diminution of the tearing force when the flaps are widely open. Careful surgery with preservation of the integrity of the capsular-zonular apparatus is a major factor in preventing major complications such as posterior capsular ruptures.