Capsulorhexis tearing pattern during phacoemulsification in anterior lenticonus due to Alport syndrome

Purpose: To describe the tearing pattern during continuous curvilinear capsulorhexis in a patient with anterior lenticonus due to Alport syndrome. Methods: A patient with bilateral anterior lenticonus underwent successful bilateral phacoemulsification and implantation of a single-piece intraocular lens. Results: The capsule tore in an atypical cogwheel-like tearing pattern during capsulorhexis. This tearing pattern likely correlates to the known ultrastructural characteristics of thinning and periodic dehiscence and breaks in the anterior capsule. Conclusions: Knowing this tearing pattern preoperatively can help to prevent capsule runoff and capsule rupture.