This presentation reviews an anterior capsule puncture in a patient undergoing capsulotomy. After lysing posterior synechiae in an eye with a small pupil, Dr. Soosan Jacob accidentally punctured the anterior capsule when the anterior chamber shallowed. Dr. Jacob and an expert panel consider options such as encircling the puncture site with a manual continuous curvilinear capsulorrhexis and converting to a can-opener capsulotomy. They also discuss the utility of the flap-motility sign.

This video is part of Cataract Spotlight 2022.