This 94-year-old patient presents with cataracts and pseudoexfoliation syndrome, with the right eye having more stability and the left having less, as seen in Figure 1.
Given that the patient is a nonagenarian, the ocular structural tissues are already fragile. When you combine that with the progressive zonular weakness of pseudoexfoliation, the risk for intraoperative capsular bag loss, pseudophacodonesis or postoperative IOL dislocation escalates dramatically.
The patient first had successful cataract surgery of the right eye, which had less pseudoexfoliation fibrillar material and better