ICE syndrome presents particular challenges for the performance of cataract surgery. Capsular staining and careful capsulhorexis are key. Also, residual ICE membrane can eventually regrow over the anterior capsule edge and IOL surface. In this video, Mauricio A. Perez, MD, and Michael E. Snyder, MD, perform cataract surgery on two patients with ICE with good results. In the first case, they use a capsular tension ring and a multi-piece prosthesis. In the second, they use a black PMMA capsular tension ring with a black stain on one end and use the remaining iris to repair the cosmetic defect.