Our guest surgeon has a lot of experience in performing MSICS, even in a tough case like this with a small pupil. The challenge is that in MSICS we need to bring the nucleus out of the capsular bag and that requires a capsulorhexis of at least 5 mm in diameter. However this pupil is smaller than that and the surgeon will need to make a capsulorhexis without directly visualizing the capsule edge. We have shown this before in phaco cases performed by me. The technique is very good and I am convinced that all cataract surgeons must learn MSICS because there are cases where it is better than phaco!
beautiful