Difficult Situation – Pseudoexfoliation, Rigid Miotic Pupil, Subluxated Cataract

Dr.Sajjad Fazili

Fazili Eye Care Center, Srinagar, J & K , India

Pseudoexfoliation is associated with ocular hypertension and glaucoma , poor pupillary dilatation, and a tendency towards lens subluxation , related to zonular alterations.
The complications related to surgery in pseudoexfoliation , are more related to the weak zonular connections rather than poor pupilary dilatation.

The poor pupillary exposure is countered by use of iris hooks. After a ccc is completed , the hooks are removed from the pupillary margin and placed on the rhexis margin, ensuring a stable bag during phacoemulsification. The CTR is placed before IOL insertion