Just looking at these two screenshots makes me take a deep breath. The anterior lens capsule is supposed to be taut like the head of a drum. With the relatively sharp tips of these forceps, I should be able to easily puncture the lens capsule to start the capsulorhexis. But I am just not able to pierce the anterior lens capsule despite multiple tries. Sure, a sharper instrument like a bent needle / cystotome would penetrate better (I used something else — watch the video), but there is certainly some underlying zonular laxity. How would you proceed now for the rest of the case? Would you put in a capsular tension ring? What are the subtle clues during surgery which give you more warnings about capsular support? My best pearls are in this complete cataract case, shown start to finish.
