Performing cataract surgery in a uveitic eye with a collapsed anterior chamber is one of the most demanding scenarios in anterior segment surgery. The primary challenge is the lack of working space, often compounded by dense posterior synechiae and a pupillary membrane that further shallow the chamber. Management begins with stabilizing the intraocular environment. Intraoperatively, the use of a cohesive viscoelastic is helpful to deepen the chamber and create a surgical space for maneuverability. Careful synechiolysis and the use of pupillary expansion devices, such as iris hooks are necessary to visualize the lens. Given the friable nature of the iris and potential for zonular weakness, a meticulous capsulorhexis and gentle hydrodissection are paramount to avoid further complications like iris-lens touch or capsular rupture. In the post-op period, steroids must be given to quell the inflammatory response.
