This patient is in his late 40s with a phthisical right eye and a dense subluxed cataract in this left eye. I knew preoperatively his zonular status would be an issue, but it became apparent that significant zonular loss jeopardized use of the bag for IOL fixation. I had to make a decision during surgery to maintain the bag a capsular tension ring, Cionni modified CTR or standard CTR + Ahmed segment vs. removal of the bag and iris or scleral suture fixation or AC IOL. Postoperatively this patient has done well with good vision. Long term prognosis wi;l depend on his ability to avoid fist induced trauma (which got him to this situation in the first place). Video by Jason Jones, MD.
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