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A 30-year-old male presents for cataract surgery. VA was 20/150 in the OD and 20/400 in the OS FE reveals nystagmus, microcornea, iris and ON coloboma, and a cataract OU. The genetics department suggested bilateral MAC spectrum. UBM identified zonular weakness. We demonstrate the use of iris hooks and CTR for IOL implantation. Final BCVA was 20/60 in OD and 20/150 in the OS.