Surgical approach, histopathology, and pathogenesis in cataract associated with true lens exfoliation

We report a case of true exfoliation of the crystalline lens in a 53-year-old baker who presented with reduced vision due to cataract. Phacoemulsification cataract surgery with intraocular lens implantation was performed, and the anterior capsule was analyzed histologically. Preoperative clinical and anterior segment optical coherence tomography observations are presented, with a description of the modified phacoemulsification technique and histopathology. A possible mechanism of pathogenesis is proposed in the context of the histopathology.