This patient exhibits severe corneal gutatta with an endothelial cell count of 368 cells/sq mm, and an extremely shallow anterior chamber. I first perform a pars plana vitrectomy to deepen the anterior chamber followed by cataract surgery using techniques intended to protect the already compromised endothelium. Because of the patient’s anatomy, I again choose to use the Trendelenburg position to obtain better access to the eye. I think you will really enjoy this case!
Pseudoexfoliation, zonular laxity, poor dilation, a shallow anterior chamber and a convex anterior capsule are all present in this 85 year old patient.