Capsulorrhexis in capsular delamination.

Separation of the anterior layer of the lens capsule, also known as true exfoliation and capsular delamination, has become an increasingly rare clinical finding. Although its pathogenesis is not precisely known, the condition has been associated with age, trauma, and exposure to toxins and/or to thermal radiation. An association with occupational infrared radiation exposure was accepted after Elschnig described the classic clinical findings in 2 glassblowers and Kubik and others noted the condition in blacksmiths, puddlers, chainmakers, and steelworkers. With improved safety standards, the condition is now reported less frequently in association with occupational hazards. Capsular delamination remains of interest particularly because there may be mild subclinical forms of the condition, and because modern cataract surgery is dependent on successful anterior capsule removal.