This woman presented at age 83. She was known to have exfoliation syndrome with poor control of her intraocular pressures in both eyes despite maximum tolerated medical therapy. At the time of presentation she had 20/100 vision OD and 20/250 vision OS. Her intraocular pressures were 27 mmHg OD and 52 mmHg OS. She underwent an intracapsular cataract extraction with trabeculectomy OS and had a good visual and intraocular pressure outcome. Note: This clip is presented both under exfoliation syndrome and ectopia lentis.