An 87 year old patient presents with a dense brunescent nuclear cataract, pseudoexfoliation and a central corneal dry spot with opacification. Enhancing my visualization is key, as is being able to constantly visualize the edge of the anterior capsule during phacoemulsification. The use of my second instrument to protect the posterior capsule is also discussed.
An eye with pseudoexfoliation exhibits moderate zonular laxity and a small pupil that requires enlargement. The options (capsule tension ring, capsule retractors, or a manual