“The toughest case of my life” is quite a statement when it is said by a highly experienced, expert level surgeon. This video is from Dr Pradip Mohanta who has done tens of thousands of surgeries over the past few decades. He is undoubtedly a very talented surgeon and when he sent this video with that caption, I was mesmerized. This patient has an iris coloboma with zonular loss / weakness in that quadrant and a nanophthalmic eye with microcornea and small pupil. In addition this cataract is quite dense and the patient is truly monocular. The pressure is on! There is so much to be learned from this case. I know that you will enjoy watching it.