Capsulorhexis Drylab for Training at Home - the Ultimate Guide
- Atanas Bogoev M.D.
- Jul 6
- 6 min read
Updated: Aug 3
Capsulorhexis (the creation of a continuous circular opening in the anterior lens capsule during cataract surgery) is one of the most critical skills for any ophthalmologist performing phaco. Mastering this technique strengthens your hand–eye coordination, improves microsurgical precision, and lays a solid foundation for safe and efficient cataract surgery.
Similar to every surgical step, a bad capsulorhexis most often leads to exponential problems as the surgery progresses, with complications such as anterior capsule tear extensions, posterior capsular rupture, or difficulty placing the intraocular lens (IOL) securely, IOL instability, and increased risk of early or late IOL rotation or subluxation. Therefore, controlled practice in a dry-lab setting (even at home) can significantly reduce surgical complications and improve patient outcomes.
While access to high-end simulators or wetlabs is ideal, it isn’t always feasible. The good news is that you can set up a budget-friendly, high-yield drylab at home or in your clinic and begin building your surgical finesse right away.
Training Objectives
Repeated practice of capsulorhexis at home allows you to develop:
Steady hand-eye coordination: vital for safe instrument manipulation, both open sky and through corneal incisions.
Understanding the dynamics of pulling the capsule
Learning resque maneuvers like Little's maneuver
Control over circular tearing: essential for avoiding radial extensions.
Finger-based (not arm-based!) instrument rotation: helps maintain anterior chamber stability.
Microsurgical depth perception: necessary for precise engagement with the capsule without damaging underlying structures.
Each of these skills is transferable to the operating room and contributes to greater surgical confidence and precision.
What you need for the capsulorhexis dry lab setup:
Option 1: Macroscopic, well-lit setup
Setup Guide with Links: How to Create a Macroscopic Dry Lab at Home
Option 2: Set up with a microscope with or without a camera.
Setup Guide with Links: How to Set Up an Ophthalmology Microscope at Home
Good visualization is essential for improving your technique and precision.
Cost | Zoom | Realism | Video Quality | |
Ring light + Smartphone | Low | Low | Basic | Moderate |
Microscope | High | High | Excellent | High |
Instruments for Home Training
You do not need operating-room-grade tools during practice to develop an effective technique. Affordable alternatives are widely available and good enough for training:
Surgical incision blades:
Capsulorhexis forceps:
Capsulorhexis forceps with round handle (recommended)
Inamura Capsulorhexis Forceps - for practicing through 1.5 mm incision (for advanced)
MST Micro-Instruments - for practicing complex anterior segment surgery through 1.0 mm incisions (for very advanced)
When buying instruments, have in mind that stainless steel is suitable for dry practice. Titanium provides marginal differences in feel but is not essential unless you prefer a more premium build.
Cystotomes: Use disposable or modified needles to initiate the flap. Always simulate a safe and gentle puncture technique.
Needleholder: For bending your cystotome needle
Instrument Storage: Store tools in a dry, padded case and clean them after each use to preserve longevity. Instrument maintenance and storage are essential. Even lower-cost instruments can maintain their performance for years if properly stored. Consider using a dedicated stainless steel instrument case with foam inserts to protect delicate tips and alignments.
My affordable instrument storage solution consists of:
Before You Start: Study the Technique
Before beginning practical exercises, study high-quality demonstrations to internalize the correct technique.
Recommended Resources:
I know most of you are very eager to start practicing imidiately, but understanding what you're doing is far more important than just doing it. True improvement comes from fundamentally understanding your actions.
My personal recommendation to your preparation approach:
If you do not have the instruments, order them.
You have 2-3 weeks of time till the instruments arrive, so use this time wisely to prepare.
Watch full-length videos without pausing. Take notes. Yes, take notes!
Slow playback speed and mirror movements with a pen or dry instrument.
Rewatch while focusing on grip and motion.
Take notes or draw step-by-step diagrams to reinforce understanding.
Capsulorhexis Practice Models Using Household Items
For those beginning or seeking low-cost options, the following models offer practical alternatives:
Aluminium foil or plastic foil over a tape roll
Stretch film (or aluminum foil) tightly over the open center of a standard roll of tape. Use a 25G or 27 G bent needle or capsulorhexis forceps to practice the circular tear. This setup provides a stable, reusable ring and better simulates the circular contour of the anterior capsule. Offers repeatability, though it lacks 3D tension.
Grape Model
Use a firm, seedless grape as a practice eye. The grape’s taut skin mimics the tension of the anterior capsule. Make a small puncture and carefully guide a circular tear, simulating the capsulorhexis motion. This method offers realistic feedback and is easily accessible, although the grape must be replaced frequently after each session.
Blueberry Model
Similar to the grape model, a firm blueberry offers a small, spherical surface with taut skin. Its smaller size is ideal for practicing fine motor control and mimics the capsular tension of pediatric or shallow anterior chambers. Due to its delicate structure, it requires even more precision to avoid tearing.
Tomato Peel Model
Practice peeling the thin skin of a tomato to simulate capsule tension and develop fine fingertip control. This is especially effective when using a soft tomato, as the skin separates more easily, closely mimicking the behavior of the anterior capsule. To achieve this, you can briefly microwave the tomato or immerse it in boiling water for a few seconds to loosen the skin without overcooking the tissue. This technique is particularly helpful for mastering delicate, tangential motion.
Aim for 10 successful attempts per model before moving to the next one to build consistency.
Low-Cost Phaco Eye-Model Training Kits
Several affordable kits are available online and are designed specifically for ophthalmic practice:
Capsulorhexis 3D Printed Model with Magnets: Featuring replaceable foil membranes that mimic the elasticity of the real capsule. You can use this with aluminium foil as well. It works great!
This is my personal recommendation for starters as it is affordable, easy to use and gets the job done.
Artificial Eyes: Reusable synthetic eyes that simulate the lens capsule. Look for versions with clear anterior chambers and realistic tension.
Choose kits with a stable mounting base and the option to order refill sheets. This allows long-term use and progression.
Track Your Progress
Record Sessions: Use a smartphone or microscope camera to film each practice session.
Review Footage: Look for inconsistencies in motion, tremors, and alignment.
Set Objectives: Track the number of complete rhexis attempts, consistency in diameter, and centration accuracy.
Create a simple logbook or spreadsheet to track date, model used, tools, score (1–5) for size, shape, centration, and tear smoothness. Alternatively, use journaling to reflect on what you learn and what you need to improve down the road.
Final Tips
Be patient. Fine motor control develops with consistent effort. It takes time.
Warm up your hands before each session with light stretching or fingertip exercises.
Use your fingertips, not your wrist, for rotating instruments. Practice this a lot.
Begin with larger tears and gradually refine to smaller, more precise rhexis circles.
Try to avoid the common beginner mistakes:
Tearing too quickly or forcefully while not understanding the vectors
Lifting the flap vertically instead of tangentially
Losing control of centration mid-rhexis
Conclusion
Developing a precise and well-controlled capsulorhexis is a foundational skill in cataract surgery, and it does not require expensive equipment to start learning. With a combination of creativity, affordable tools, and structured practice, you can effectively train at home.
Stay consistent, track your progress, and reflect on refining your skills.
Over time, your improved control and confidence will carry over into the operating room, helping both your surgical outcomes and your patients.
Make sure to follow @atanasbogoev on Instagram for more surgical training ideas at home.
Disclosure: This webpage contains affiliate links, which help support us and keep the website running. The recommendations are genuine and are NOT sponsored. Explore other options yourself, and if you find something better, let us know so we can include it. ABOUT THE AUTHOR
Atanas Bogoev, M.D., FEBOÂ is a consultant ophthalmologist, eye surgeon, and co-founder of Ophthalmology24. Atanas has trained internationally, attending courses at Harvard Medical School, Oftalmo University, and completing observerships such as the GAASS program in Toronto. He combines surgical experience with a passion for education, translating surgical best practices and clinical learning into accessible resources.