The free crystalline proteins in the anterior chamber could lead a serious inflammation. Furthermore, the impact of a Nd:YAG laser will break the anterior capsule in an very irregular pattern, which carries the risk of a runaway rhexis.
Actually was just curious about using Nd Yag before the surgery, so tried in wet lab but the result was disappointing. The idea was to use in difficult cases and at a much cheaper rate as compared to lensx.
If some one could develop Nd Yag delivery in a hollow circular fashion may be we can achieve CCC.
Femtosecond laser machine was constructed to make multiple capsula micro defects. It seems to be much more precise procedure than effect of the Nd YAG laser disruptor. However, manual capsulorhexis remains.