CataractCoach™ 2284: Cataract Quiz: What is this dark crescent?

The CataractQuiz™ series here on CataractCoach™ is among the most popular category of videos that we publish. If you just love these quizzes then you can see all of them on the CataractCoach.com website under the Quiz heading. cataractcoach....
In this case, you are just starting the capsulorhexis when you notice a dark crescent at the pupil margin. What is that? Why did that happen? What is likely going to occur next? How will you deal with these issues? Answer below via comment prior to watching the video...

[@TheAngryLabRat]

Doing phaco here is just more time consuming and worse for the endothelium. Intracapsular extraction/MSICS + anterior vitrectomy and iris claw would be my choice for extensive zonular loss

[@Dr.OriMahler]

Using vision blue would be better for viewing the CCC. I prefer capsular hooks than iris hooks for better support. Vitrectomy should be done through the paracentesis rather than the main incision

[@mr.nicky.]

Agreed. In cases with such severe zonulopathy where there is high risk of blue transecting the zonales into the vitreous, do you put viscoelastic first and “paint” the blue on the capsule with the cannula or inject blue into AC prior to viscoelastic hoping it doesn’t go back?

[@Dr.OriMahler]

@@mr.nicky. you are right. OVD first and then the blue

[@Alzaandres]

Hello, to perform the capsulorhexis I use hard viscoelastic hyaluronate 3%

[@nadirunlu4479]

Not a well done surgery.. 😩