The simple bent needle, also called a cystotome (or cystitome for the alternate spelling) can be used to create the…
1781: resident week: posterior sub-capsular
For this resident case there is an extensive posterior sub-capsular cataract which is causing poor vision, decreased acuity, and tremendous…
1780: resident week: pseudo-exfoliation
Continuing with resident week, we present a case of pseudo-exfoliation (PXF). There is a spectrum of disease when it comes…
1779: resident week: nice chop but…
The next case in our resident week series is a routine case where this US senior resident is learning phaco…
1778: resident week: needle decompression
This week we will feature resident cases submitted anonymously from surgeons in training from around the world. Today’s case is…
1777: Curriculum Lesson 19: complications part 1
The next lesson in our CataractCoach Curriculum series is lesson 19: complications, part 1. Every surgeon encounters surgical complications and the key…
1776: refractive lens exchange for hyperopia
For patients over age 60 with significant degrees of hyperopia, a refractive lens exchange (RLE) tends to be the preferred…
1775: the IOL is sitting on the macula
This patient suffered late dislocation of the IOL+capsular bag complex and it fell into the vitreous cavity and it now…
1774: When did the posterior capsule rupture?
I have watched this video a few times and I am still not sure when the capsule ruptured. Look at…
1773: capsule ruptured by intra-vitreal injection
With millions of intra-vitreal injections being performed every year, an iatrogenic rupture of the posterior capsule by the needle is…
1772: phaco + GATT to treat glaucoma
GATT is gonioscopy-assisted transluminal trabeculotomy and it was described almost 10 years ago where the trabecular meshwork can be torn…
1771: further progression of surgical skills
When I saw case 25 from this resident (link here) I was amazed at his skill level and just how…
1770: PodCast 5: surgical learning & coaching
About six weeks ago I posted a video discussing the question, “Should you give up operating?” because it is asked…
1769: cataract in a post-trabeculectomy eye
When performing cataract surgery in an eye with a prior trabeculectomy there are some important differences. There is going to…
1768: brunescent dense rock cataract
This is a tough case and when you see the microscope lights turned up but still no red reflex, you…
1767: an amazing rescue of a tough case
Our guest surgeon, Dr Steve Safran has become an expert in complex re-operations and anterior segment reconstruction, with countless cases…
1766: when did the posterior capsule break?
Our guest surgeon, Dr Lukan Mishev, is a highly talented ophthalmologist who is an expert is anterior and posterior segment…
1765: keep the capsulorhexis centered
In this complete cataract case the pupil has dilated in an asymmetric manner. There is no history of trauma and…
1764: larger capsulorhexis for larger pupil
This patient has a large anterior segment where the white-to-white diameter is almost 13 mm. He also has a large…
1763: Curriculum Lesson 18: finish the case
This lesson focuses on finishing the case. Sounds easy, but it can be tricky. We need to remove the viscoelastic…
1762: Focus on Efficiency: putting it all together
This week we have a Focus on Efficiency. Today, putting it all together – a complete case. Over the past…
1761: Focus of Efficiency: optimal flow
This week we have a Focus on Efficiency. Today, achieving the optimal state of flow. The psychological state of Flow is described…
1760: Focus on Efficiency: cycle time analysis
This week we have a Focus on Efficiency. Today, tracking and improving your cycle time. After working with 200 ophthalmology…
1759: Focus on Efficiency: your scrub tech
This week we have a Focus on Efficiency. Today, the importance of your scrub tech. As surgeons, we do not…
1758: Focus on Efficiency: how I think
This week we have a Focus on Efficiency. Today, here is how I think to improve efficiency. This is a…
1757: Focus on Efficiency: please help me
This week we have a Focus on Efficiency. Today, a look at an experienced surgeon’s case. An anonymous ophthalmologist with…
1756: PodCast 4: Tom Oetting MD
Dr Tom Oetting is a celebrated cataract surgery teacher and he has really pioneered much of the online learning in…
1755: intumescent cataract double rhexis
Our guest surgeon does a beautiful job with this intumescent white cataract. Because the cortex has liquefied, the capsular bag…
1754: dual site phaco trabeculectomy
This patient has both glaucoma and cataracts and the clinical decision has been made to perform both cataract surgery and…
1753: single site phaco trabeculectomy
Our guest surgeon is using a single site to perform the cataract surgery and the trabeculectomy because this patient already…
1752: resident’s 3rd horizontal chop
Last week in video 1747, we showed you this same resident surgeon’s first case of horizontal chop and it went…
1751: for capsule wrinkling, I do this…
This is a complete cataract case, shown start to finish, where the anterior lens capsule wrinkles upon attempted puncture for…
1750: paired incisions for astigmatism
Doing refractive cataract surgery is becoming the norm with patients desiring correction of refractive errors at the same time as…
1749: Curriculum Lesson 17: IOL delivery
In this next part of our curriculum series, we have lesson 17: IOL delivery. It may sound simple, but injecting…
1748: tiny hyperopic eye & small pupil
Just watching this case is stressful. It is a very small eye with a 20 mm axial length, shallow anterior…
1747: A resident’s first phaco chop case
The advantage of residency training is that a seasoned attending ophthalmologist is sitting right next to you, giving advice, teaching…
1746: resident case 100 analysis
Time for some group learning and this young surgeon (and other beginning surgeons) need your input and advice. This is…
1745: Ahmed capsular segment placement
This is a tough case where the surgeons learns intra-operatively that there is a quadrant of poor zonular support. An…
1744: keratoglobus cataract surgery
Keratoglobus is a rare condition, so rare that I have never seen a patient with this condition in my career,…
1743: measure precisely for Yamane IOLs
Precisely measuring your scleral entry points is critical to center the IOL optic when you are performing Yamane intra-scleral haptic…
1742: PodCast #3: Resident Eye Surgeons
This is an amazing podcast with three senior ophthalmology residents from the UCLA Jules Stein Eye Institute (Gio Campagna MD,…
1741: defining and measuring success
Defining success is not easy because it means different things to everyone and it tends to evolve or change throughout…
1740: dead capsular bag syndrome
In rare cases, years after a cataract surgery, we can have complete loss of zonular support with dislocation of the…
1739: peeling a posterior polar plaque
We all know that posterior polar cataracts are challenging because at the site of the polar opacity the capsule can…
1738: sudden choroidal hemorrhage
This is another great example of how even an experienced, expert surgeon can encounter a complication during cataract surgery. This…
1737: IOL breaks the posterior capsule
We should never devalue cataract surgery or claim that it is such an easy procedure because even in expert hands,…
1736:capsule break from OVD bubbles
I was watching cataract surgery videos on YouTube and I saw this video from Dr Shannon Wong from Austin, Texas…
1735: Curriculum Lesson 16: IOL loading
Continuing with lesson 16 in our Curriculum series, focusing on IOL loading. Every surgeon must know how to load the…
1734: the 7L rule saves the day
The 7L rule has been passed down from one generation of ophthalmologists to the next for many decades. It is…
1733: Can you do MSICS without a peritomy?
Today I have more questions than answers. I enjoy performing the MSICS technique and even in our Beverly Hills surgical…