Approach cataract surgery with care in presence of PXF

Cataract surgery in the presence of pseudoexfoliation (PXF) of the lens presents surgeons with unusual challenges. In addition to a higher incidence of glaucoma, these patients have loss of zonular integrity occasionally associated with lens subluxation and pupils that dilate poorly. Although the use of phacoemulsification in experienced hands has resulted in a low incidence of intraoperative and postoperative complications such as zonular dialysis, capsule tears, vitreous loss, and IOL decentration,1 special care should still be exercised when performing cataract surgery in these patients. Improvements in phacoemulsification technology, technique, and capsular supporting rings should ultimately enable these patients to undergo