Fig. 87. Extensive posterior capsule opacification (PCO) exists in this patient with pseudoexfoliation who received an implant of a single-piece AcrySof® IOL implanted in the capsular bag. The posterior capsule was flaccid because of weak zonular attachment, so no capsular vacuuming had been performed, which permitted early PCO. This contributed to capsule contraction and pseudophakodonesis, which resulted in chafing of the posterior iris pigmented epithelium and consequent iris transillumination. (Courtesy of James A. Davison, MD, Wolfe Eye Clinic, Marshalltown, IA.)