This patient has pseudoexfoliation, shallow anterior chamber, dense nucleus, lax zonule and poor pupillary dilation. I have previously demonstrated the use of capsular retractors for zonular laxity, but here we will see the latest version of these devices as modified by Dr David Chang. I also discuss the causes of chopping difficulties, demonstrate “verticalizing” the chopper, use of a CTR, and discuss IOL selection based on intraoperative findings.
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