Here is a complete list of all videos sorted by category. This list will be continuously updated as we post…
Review: fixing beginner mistakes
Learning intra-ocular surgery is not easy and it can take years just to be comfortable with just the basics. Look…
The Subtleties of Cataract Surgery
The difference between good cataract surgery and great cataract surgery comes down to subtleties. There are very slight nuances to…
Bilateral brunescent cataract surgery
This patient has been functionally blind for 10 years and presents to us with bilateral, dense, brunescent cataracts. We must…
Quiz: What is different about this cataract?
Look carefully at the picture above and you will see something that is different about this white cataract. It is…
Resident Cataract Surgery Final Exam
Today is June 30 and that is the final day of residency training in the USA since our academic year…
Analysis of Resident Surgery Steps
This video features side-by-side double camera angles so that we can simultaneously see the microscope view as well as the…
Fluidic Analysis during Phaco Chop
It can be helpful to see the machine fluidic parameters in real-time as the phaco chop procedure is performed. We…
Review: capsule attachments with femto-laser
This young patient (about 40 years old), developed a white cataract which has severely impaired vision in this eye for…
Paired Incisions to fix Astigmatism
This is an easy technique that can be so helpful to all cataract surgeons. By using paired phaco incisions, we…
Pearls for small pupil cataract surgery
There are some great surgical pearls for dealing with small pupils during cataract surgery and this video explains some of…
Cataract Quiz: Why shift the capsulorhexis?
Looking at the picture above it seems like the capsulorhexis has been shifted nasally: it is much closer to the…
Complete Case: Cortical Cataract
With a cortical cataract, patients are very symptomatic, particularly if the cortical opacities are within the visual axis. These tend…
Resident Case Double Camera Angles
For experienced surgeons (which I define as those who have done at least a few thousand cataract surgeries), the microscope…
Complete Case: a very special patient
As a surgeon, it is always an honor when a colleague trusts you to operate on his eyes or on…
Review: Cataract surgery after prior RK
This patient was very myopic and desired surgical correction many years before the advent of the excimer laser. As such,…
Use Trypan Blue dye before OVD
Trypan Blue dye is very useful in cataract surgery because it can stain the anterior lens capsule which improves visualization…
Complete Case: loose zonular support
Another great video in our series of Complete Cataract Cases: a dense cataract in the setting of loose zonular support.…
Anterior Capsule Rips Uncontrollably
Quiz time: What do you do when the anterior capsule rips uncontrollably in a young patient who is scheduled to…
Complete Case: vertical phaco chop
Another complete cataract case, this time showing the vertical chop technique to split the cataract into two halves. This is…
Resident surgeon does case #100
For all of our young surgeons who are learning cataract surgery, this is a great video because it shows you…
resident toric IOL case double camera angles
Using double camera angles can help newer surgeons learn the nuances of surgery. This video shows a resident surgeon who…
Review: Optimizing Cycle Time Efficiency
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety.…
Should you do surgery for this patient?
This is a complex patient who has many systemic medical issues and because her lab tests from this morning showed…
Complete Case: Efficient Phaco Chop
Another great video in our series of Complete Cataract Cases. You’ll be able to learn from the very first incision…
Quiz: Should I have used a pupil ring?
This is a tough case and the pupil is smaller than I expected. Should I have used a pupil expansion…
2 approaches to Posterior Polar Cataracts
Studies have shown that 1 out of 3 posterior polar cataract surgeries result in a ruptured posterior capsule. Here’s the…
Pre-Chop with just 2 Choppers
Guest surgeon Dr Valentin Apostolov from Amsterdam shows us his technique for splitting a dense nucleus into small fragments before…
From routine case to disaster in 1 second
When I first saw this video, which was submitted by an anonymous surgeon, I was in disbelief. I simply could…
Review: The Angle of Approach for Incisions
The angle of approach of the keratome will determine the tunnel length of our phaco incision. If the angle is…
Tough cataract case for a resident
We are thankful for the many video submissions we receive from our readers, particularly from residents or registrars who are…
Lessons Learned with 3-piece IOLs
Most cataract surgeons now use single-piece acrylic IOLs for the majority of their cases, with three-piece IOLs reserved for unusual…
Cataract Quiz: IOL with capsule tear
Cataract Quiz time: you have removed the lens nucleus and the cortex and you see that the anterior capsular rim…
Enlarge the Capsulorhexis
A small capsulorhexis makes nucleus removal more difficult, especially when we have a dense cataract. When the entire lens hardens…
Complete Case: Floppy Iris & Loose Zonules
There is a benefit to watching a video of a complete cataract case, from start to finish. This is particularly…
Recovering from Argentinian Flag Sign
We have an entire section devoted to achieving success with white cataracts, including intumescent white cataracts. But even in expert…
Cataract Surgery in MegaloCornea
This patient has a huge cornea with a diameter of about 14 mm and an equally large anterior segment including…
Staying calm when you see danger signs
The second that I see this round hole, I know that it is a danger sign. We have previously explained…
Does cataract surgery pose a viral risk?
Our colleagues from the University of Toronto recently did an experiment to determine if cataract surgery poses a risk of…
Cataract Quiz: Which direction for capsulorhexis?
In this Cataract Quiz we have a patient with a white cataract and as we start to tear the capsulorhexis,…
Should you use a trifocal IOL in Fuchs’?
This is an unusual case: the patient has Fuchs’ Corneal Dystrophy and yet we are implanting a trifocal IOL. Usually,…
Intra-scleral Gore-Tex IOL fixation
This young patient sustained severe ocular trauma a few years ago and he had a surgical repair done in another…
Descemet Membrane Detachment
When we make a phaco incision that involves the cornea, there is always a risk of having focal detachment of…
Review: Small Eye with high power IOL
Cataract surgery can provide an incredible refractive result, particularly for small eyes which are highly hyperopic. We can correct 10…
Double Hydro-Delination Technique
Hydro-delineation is a useful technique which allows us to separate a central endo-nucleus from an epi-nuclear shell. In this case,…
Lessons from COVID-19
We are now back in our clinics seeing routine patients after almost 2 months of hiatus due to COVID-19. The…
Cataract Quiz: What do you do now?
This is a complication that is sure to happen to every beginning cataract surgeon: a broken posterior capsule as a…
Complete Case: PXF supra-capsular chop
The previous case (reference 611) from yesterday, showed the first eye of this patient where the technique was phaco chop…
Complete Case: PXF chop in the bag
Today (video 611) and tomorrow (video 616) are the two eyes of the same patient who has pseudo-exfoliation syndrome and…
Hydro-delineation makes chopping easier
Performing hydro-delineation helps to separate the denser, central endo-nucleus from the softer epi-nuclear shell. This endo-nucleus is smaller in diameter,…
Review: Chopper protects the capsular bag
We work in a very tiny space of just a fraction of a milliliter: the volume of the anterior chamber…
Toric IOL use in Radial Keratotomy
We have featured many videos of cataract surgery in eyes with prior radial keratotomy. Many of these patients seek out…
Techniques to Open DMEK Grafts
Today was supposed to be the World Cornea Congress in Boston (May 14, 2020) and even though it is cancelled,…
Fixate the eye with your other hand
The problem with using two hands to hold the capsulorhexis forceps is that you lose the ability to have the…
Examine instruments before using them
We must examine our instruments before using them to ensure that they are intact and in normal, working condition. In…
Show me a beautiful cataract surgery
Here on CataractCoach.com we have hundreds of teaching videos, and many of them are of very complex or complicated cases…
Newbie Resident Cataract Surgery
Even experienced surgeons can learn by watching novice surgeons operate. A nickname for a novice is a newbie since the…
Review: Embed the phaco tip without ultrasound
This review is particularly important for ophthalmologists who do cataract surgery for patients with mild to moderate nuclear density. This…
Pre-Chop Variations for Cataract Surgery
In this video, submitted by Dr. Yaun Lin from Casablanca, Morocco, we can learn multiple different variations of Pre-Chop. This…
Expulsive Choroidal Hemorrhage!
This video is a MUST SEE! An expulsive choroidal hemorrhage is a rare complication than any cataract surgeon must be…
Cataract Quiz: Chopper breaks zonules
The resident surgeon has good hands and is talented, but like all new surgeons, he is lacking in experience. The…
Posterior capsule rupture – finish the case
This resident case is a challenge: the posterior capsule is ruptured but there is still cortex to be removed. Can…
Benchmark: Senior Resident Chop
This is a good benchmark for what a senior resident should be able to achieve by the end of residency…
Capsulorhexis forceps with ruler marks
Our guest surgeon is Dr. Ron J. Smith who has been instrumental in teaching cataract surgery at UCLA for the…
Review: IntraCameral Medications
Putting medication directly into the anterior segment of the eye can be very effective. There are many different medications that…
DMEK surgery with pre-loaded graft
We have previously featured Descemet Membrane Endothelial Keratoplasty here on CataractCoach with a video from one of my residents and…
Seems like a good chop but…
Another video for our series of Complete Cataract Cases, we present a surgery of me operating. During this surgery, I…
Cataract Quiz: Rescue this Rhexis!
For this Cataract Quiz we have guest surgeon Dr. Naveen Gopal from Bangalore, India showing us a tough case that…
Congenital Iris Coloboma Repair
We have another video from master surgeon Dr. Valentin I. Apostolov from Amsterdam. In this video he shows us his…
Trabeculotomy & Cataract Surgery
Because cataract surgery alone tends to decrease intra-ocular pressure, there is often a benefit of combining it with glaucoma surgery.…
Resident Surgeon Stop-and-Chop
This is an anonymously submitted video of a resident performing cataract surgery number 60 and the technique is stop-and-chop. This…
Review: Rule of 9s for Sulcus IOL Power
With newly developed methods of IOL power calculation, we are approaching 90% or higher accuracy of achieving +/- 0.5 D of…
Pupillary Cerclage Technique
In cases of chronic traumatic mydriasis, we can use sutures to reconstruct a pupil of a reasonable diameter. We have…
Lens Snare Technique
More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to…
Cataract Quiz: Why did this IOL decenter?
The patient underwent a combined cataract surgery with pars plana vitrectomy. The cataract surgery went well and even today, 1…
Predicting Pseudo-Exfoliation weakeness
We have previously covered the topic of pseudo-exfoliation (PXF) in detail here on CataractCoach. It is an important topic because…
Do not make a baby capsulorhexis
Making small capsulorhexis makes the cataract surgery more difficult because it limits access to the capsular bag and makes it…
IOL cartridges – which one?
There are many different IOL injector systems from multiple different IOL manufacturers. It is the surgeon’s job to know the…
Review: Why LRIs should be done at the end
Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract…
Cataract Surgery with Asteroid Hyalosis
Asteroid hyalosis is a rare condition where patients have calcifications throughout the vitreous jelly. It occurs in about 1-2% of…
Secret to Chopping Dense Cataracts
For the phaco chop technique, the nucleus is held stationary by the vacuum level of the phaco probe. This is…
Cataract Quiz: What’s your next move?
You are performing routine cataract surgery and then you suddenly notice that the posterior capsule is open and a nuclear…
Ensuring accuracy of A-scan ultrasound
Correlate A-scan & biometry measurements to improve accuracy in IOL calculations. This case shows how disparate measurements can lead to…
Toric IOL technique with a small pupil
The toric IOL is a great option to address astigmatism at the time of cataract surgery. For the toric IOL…
How to Enlarge a Small Capsulorhexis
Making a small capsulorhexis can make the cataract surgery more difficult. It becomes challenging to bring nuclear pieces out of…
Review: Differentiating White Cataracts
You’ve seen the notation in the patient chart: “DWC” which stands for Dense White Cataract, but there is actually a spectrum of cataracts…
Step-by-step: Malyugin Pupil Ring
To perform cataract surgery in an eye with a small pupil, it helps to expand the pupil to a more…
How to recover from a capsule rupture
It happens to all surgeons, and it is much more common in beginning surgeons: rupture of the posterior capsule during…
Cataract Quiz: When did the bag break?
In this anonymously submitted resident video, there is a break in the posterior capsule during cataract surgery. With the assistance…
Do not withdraw infusion with a capsule break
If there is a break in the posterior capsule, withdrawing the infusion will allow the anterior chamber pressure go to…
Glaucoma Seton Drainage Surgery
In cases of intractable glaucoma, implanting a seton drainage device can be a very effective therapeutic option. The seton tube…
Scleral-sutured IOL with GoreTex
This is an unusual case of prior trauma. A 13 year old boy was playing with fireworks and sustained a…
Review: Dispersive vs. Cohesive Viscoelastics
Viscoelastics, also referred to as OVDs (ophthalmic visco-surgical devices), are viscous substances that allow us to make phaco-emulsification easier and…
Capsulorhexis Pivoting
The key to making a great capsulorhexis is understanding the pivoting technique. This allows us to float within the incision…
IOL delivery technique
While it seems relatively easy to insert the IOL with an injector system, there are subtleties in the technique which…
Pit Technique for Dense Cataracts
With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult.…
Complete Case: Soft Cortical Cataract
Another addition to our series on Complete Cataract Cases is this technique for soft cortical cataracts. These cataracts are typically…
Capsulorhexis: Good vs Great
In this picture, the capsulorhexis on the left is good because it is centered, continuous, and an appropriate size, but…
Artificial Intelligence in Ophthalmology
The future is here and John Ladas, MD, PhD gives us a brief lecture about the Rules of the Game…
Review: Why is Phaco Chop not working?
This patient certainly needs cataract surgery because the dense nucleus has a large degree of central opacity and that has…
Toric IOL Alignment Dilemma
In this picture, all of these lines are at the 120 degree meridian, so how do you choose where to…
Leukocoria in a newborn baby
Leukocoria in a newborn baby is an urgent situation that needs immediate attention from an ophthalmologist. The cause of the…
Cataract Quiz: Where should you make the incision?
Our phaco incisions will induce an astigmatic change in the cornea and we can use that to help achieve a…
Complete Case: Cataract in a Small Eye
Looking at this picture, we can see that the corneal diameter is very small compared to the size of the…
How to Evacuate this Hyphema
This patient was struck in the eye with a Champagne cork, which was traveling at a high velocity and hit…
How to Rescue this Capsulorhexis
We have previously discussed the Little Maneuver which is a method of saving a run away capsulorhexis. In this case,…
Review: Pseudo-Exfoliation Cataract Surgery
Pseudo-Exfoliation / Small Pupil / Weak Zonules / Shallow AC (watch video below) A sweet 80 year old patient comes…
Danger: Clear Crescent Red Reflex
When you are mobilizing a dense nucleus and you briefly see a bright, clear, crescent-shaped red reflex, you can be…
Manual SICS with nucleus bisection
SICS is small incision cataract surgery, and it refers to a method of manual expression of the nucleus through a…
Cataract Quiz: What happened here?
Look carefully at this picture: what do you see? There is a three-piece IOL in the sulcus and there is…
The Chopper Push Technique
Watch this video carefully and you will see that the chopper instrument is used just once to create a single…
Complete Case: Chop in the Bag
Again we have a complete case, from start to finish, showing a routine cataract surgery with a phaco chop technique.…
You must learn this before finishing residency
The challenge of residency training is that you have just a limited time to learn surgery. You can read books…
Review: Phaco Incision OCT Analysis
The phaco incision is part of your signature which links you to the patient’s eye forever. Your incision will forever be visible…
Mentally Recovering from Complications
There are only two types of ophthalmologists who never, ever get surgical complications: (1) those who don’t operate, and (2)…
Complete Case: Flomax & Toric IOL
Many of our CataractCoach.com readers have been asking for complete cases, shown from start to finish. There is a lot…
Cataract Quiz: What is hidden in this pic?
Look carefully! There is something that needs to be addressed in this picture — it is not easy to see,…
Cataract Surgery with Pterygium Present
For a patient with both a pterygium and a visually significant cataract, the best option is usually to do the…
Mastering IOL Flange Techniques
In cases of insufficient zonular support, using a flange technique has become popular after Dr Shin Yamane shared his technique…
What are these lines? What is Reflux?
These lines are the posterior capsule which has found its way into the suction port of the I/A probe. We…
Review: Optimizing Cycle Time Efficiency
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety.…
Posterior Polar without delineation
Posterior polar cataracts are unusual, but certainly every ophthalmologist will see these patients in their own clinics. While most surgeons…
Posterior Capsule Rupture! Now what?
In this anonymously submitted case from a resident surgeon in training, there are many great lessons to be learned. We…
Cataract Quiz: Optic-Iris Capture
Happy New Year! It’s Quiz Time: how do you approach this case with optic-iris capture and a dense fibrotic membrane?…
How much force for hydro-dissection?
When we perform hydro-dissection, how much force is needed? What volume of balanced salt solution is required? What are the…
Refining your Surgical Signature
It is so important for surgeons to take pride in their work. You must do a great job, or don’t…
Setting Up for Cataract Surgery
Cataract surgery is team work and the surgeon is just one member of the team. We need a great team…
Review: Posterior Capsulorhexis Technique
If there is a central posterior capsule plaque that cannot be removed with the suction from the irrigation/aspiration probe, we…
Epi-Nucleus Flip Technique
With a thick epi-nuclear shell, it is easier to remove it with the phaco probe as compared to the I/A…
Fix this Iris Prolapse in 2 seconds
Really. This is not an exaggeration. If you understand the physics of why the iris is prolapsing through the incision,…
Cataract Quiz: The chop failed. Now what?
Even for expert cataract surgeons, sometimes the attempt at phaco chop fails. This can be due to many reasons and…
Resident Cataract Case #165 Evaluation
This video is submitted anonymously by a resident ophthalmologist who has completed 164 cataract surgeries so far. This case, his…
Trap a dense nucleus in order to chop it
With a very dense and fibrous cataract, using just the vacuum from the phaco tip to hold the nucleus is…
Cortical Cataracts can cause “white-out”
Cortical cataracts occur when some of the lens material becomes liquefied, thereby blocking the visual axis. When we perform hydro-dissection…
Review: External View of Cataract Surgery Steps
Two of the most critical steps in cataract surgery are the main phaco incision and the capsulorhexis. Properly completing these…
Phaco Chop in patients over age 90
In previous videos we have explained the differences when operating on nonagenarian patients. These patients have weaker tissues such as…
Toric IOL planning in a small eye (+29.5 D)
Our main phaco incision will induce astigmatism and multiple variables affect the degree of this change. Larger incisions have more…
Cataract Quiz: What is the problem here?
Time for another Cataract Quiz. Look carefully at the photo — the IOL has just been implanted and now it…
Complete Case: Brunescent & White Cataract
This patient truly needs our help. She developed a cataract in the right eye a few years ago and was…
The surgeon will struggle to finish. Why?
In this resident surgeon case, the anterior chamber flattens and there is loss of viscoelastic upon attempted manipulation of the…
The Smallest Permissible Capsulorhexis
From watching our videos, you know that for most cases, I find that a 5 mm capsulorhexis is ideal. This…
Review: Side View of Hand Position
While we do hold the phaco probe with a pencil grip, we do not use the same angle as writing with…
Trouble learning phaco chop? Try this first
One of the main reasons why phaco chop is more difficult to learn than divide-and-conquer is that there is a…
The patient has a surprise for you…
You have scheduled a patient for cataract surgery and the case seems relatively routine. The biometry was good and the…
Cataract Quiz: Why is there a capsular wrinkle?
This surgery seemed quite routine. A nice capsulorhexis, easy nucleus removal, and complete cortex clean-up. The three-piece IOL was placed…
Peeling off a Pupillary Membrane
In this complex case, there is a nearly complete pupillary membrane in an eye with a cataract and a prior…
Complete Case: Dense PSC & Shallow AC
This is a complete case, shown from start to finish. For many of our CataractCoach viewers, particularly the surgeons with…
Checking the IOP at the end of surgery
We want to ensure an appropriate intra-ocular pressure (IOP) at the end of surgery. This puts the eye in a…
Review: IOL calcs in high hyperopia
Here is your challenge. You’re operating on a patient who is highly hyperopic (wearing +6.50 OD and +7.00 OS for…
Three-piece IOL: B versus C cartridge
There are two options for injecting an Alcon three-piece IOL using the Monarch injector: the B cartridge is bigger and…
Why implant a zero power IOL?
This patient is ultra-myopic with an axial length of more than 31 mm. Using the free calculator at IOLcalc.com we…