A young doctor in training asked me to put together a list of key videos prior to her first day…
1034: Playlist: IntraOp OCT Scan
The intra-operative OCT scan is a rarity in ophthalmic operating rooms because of its cost which can add $60,000 to…
1033: USA resident’s first phaco chop
This video shows a resident surgeon’s first phaco chop. The key is that the resident is putting the effort to…
1032: Portugal resident’s first phaco chop
This video shows a resident surgeon’s first phaco chop. The key is that the resident is putting the effort to…
1031: resident phaco chop critique
Our video is from an anonymous resident surgeon in The Philippines who is performing a phaco chop variant during this…
1030: Your Surgical Skills at Case 300
Where should your surgical skills be after 300 cases? We have previously explained the learning curve for cataract surgery and…
1029: First year in practice Cataract
Our guest surgeon showcases his stop-and-chop nucleo-fractis in a routine cataract surgery and his technique is excellent. He finished his…
1028: Keys to Cataract Surgery Efficiency
If you have performed fewer than 10,000 cataract surgeries, you are still in the part of the learning curve where…
1027: Playlist: Pseudo-Exfoliation
Cataract surgery in the setting of pseudo-exfolation is particularly challenging due to the structural weakness that occurs with this disease…
1026: suturing the IOL to the iris
Our guest surgeon shows us his technique for suturing an IOL to the iris in a patient with long-standing peudo-exfoliation…
1025: Soemmering’s Ring Extraction
Our guest surgeon, Dr Val Apostolov from Amsterdam, is a frequent contributor to CataractCoach and today he shows us a…
1024: SICS for uveitic cataracts
This is a case of a cataract with extensive synechiae due to prior uveitis. The eye is quiescent now, with…
1023: Foreign body capsule rupture
This patient sustained a serious ocular injury: a foreign body pierced the cornea, punctured the anterior lens capsule, and now…
1022: Suprachoroidal hemorrhage
A suprachoroidal hemorrhage is a dreaded complication that can happen with any intra-ocular surgery. We most commonly see it during…
1021: the nucleus drops during phaco
This anonymously submitted video shows a complication from a resident cataract surgery. The capsulorhexis radializes in the sub-incisional area and…
1020: Playlist: Complications
Complications happen to all surgeons, no matter how much experience we have. It is true that a surgeon who has…
1019: from one chop to the next
This complete cataract case shows how we move from the first chop to the next in order to efficiently break…
1018: the many uses of the chopper
The phaco chopper instrument does more than just chop the nucleus. We use it to pull nuclear pieces out of…
1017: complete case with dense endo-nucleus
This complete cataract cases features a younger patient who developed bilateral cataracts with a dense endo-nucleus. We also implant a…
1016: flip and chop in high myopia
This is a patient with a large degree of myopia and a relatively dense cataract. And it is a good…
1015: phaco flip + chop in pseudo-exfoliation
This complete cataract case features an elderly patient with a dense cataract and pseudo-exfoliation. We use the flip and chop…
1014: Cataract after prior vitrectomy
This week we are doing complete cataract cases where we will show an entire surgery from start to finish and…
1013: Playlist: Glaucoma Cases
The most commonly performed glaucoma surgery is…. cataract surgery! We know that doing cataract surgery alone can lower intra-ocular pressure…
1012: Resident White Cataract Chop
The drive to continually improve our surgical skills starts in residency and then continues for the rest of our careers.…
1011: Opacified IOL Exchange
While it is rare, some IOLs can become opacified with time. This has been reported primarily with hydrophilic acrylic materials…
1010: Bimanual Phaco Technique
About 15 years ago, bimanual phaco was relatively popular. The idea is that by separating the infusion from the aspiration,…
1009: Cutting a Fibrotic Lens Capsule
In some white cataracts, the lens capsule can become fibrotic as the lens cortex becomes absorbed and the capsule contracts.…
1008: Horizontal Chop Technique
Our guest surgeon is Dr Hafidi Zouheir from Rabat, Morocco and he expertly demonstrates the horizontal chop technique for a…
1007: IOL calculations with retinal disease
Today we present a quick review of IOL selection and calculations when performing cataract surgery on patients with retinal disease.…
1006: Playlist: Indian Surgeons
Our ophthalmology colleagues from India have brought a high degree of expertise to cataract surgery. Over the past decades, I…
1005: Resident’s first Anterior Vitrectomy
Every cataract surgeon will experience a ruptured posterior capsule and vitreous prolapse as a complication. The key is to recognize…
1004: Preventing Capsular Rip in white cataracts
This 30 year old patient has a tough situation: bilateral white cataracts with high pressure within the capsular bag. There…
1003: Why did the patient go elsewhere?
This video shows two complete surgeries, both presented at high speed. The original cataract surgery was performed by me and…
1002: Do not upset the iris!
There is a lot to learn from this resident cataract surgery. The case starts out with a reasonable pupil of…
1001: Ahmed Glaucoma Valve Technique
Our guest surgeon today is Victoria Tseng, MD, PhD who is a glaucoma specialist and professor at the Jules Stein…
1000 posts/videos on CataractCoach
Back in May of 2018, I had the idea to start CataractCoach.com where I would routinely post about cataract surgery,…
999: Playlist: Toric IOLs
For the correction of astigmatism at the time of cataract surgery, toric IOLs can be an excellent option. The best…
I wish I had this book in residency!
“What your medical school and ophthalmology textbooks can’t teach you, but what your mentors, colleagues, and patients will!” That really…
Capsular Tension Ring Placement
Our guest surgeon is Dr. Bhagyashri Deshmukh from Amravati, India and she is presenting a traumatic cataract case with a…
iris claw lens to address aphakia
Another excellent video from our colleague Dr. Val Apostolov from Amsterdam. In this case there is a patient with a…
highly myopic cataract surgery
These are some of the most rewarding cataract surgeries to perform since we can correct the cataract as well as…
considerations for monocular patients
Monocular patients present a special situation that can differ from a routine case in a patient with two eyes. We…
white cataract needle decompression
This patient is a good candidate for needle decompression because the intumescent cataract has a distinct fluid layer and we…
Playlist: Brazilian Surgeons
The first time I went to Brazil, it was an amazing experience because of the passion. And this applies to…
Anterior Chamber Phakic IOL removal
Phakic IOLs are useful to address extreme degrees of myopia, but there are potential complications. Previously, we have featured cases…
Routine Cataract Case for Myopic Patient
Complete Cataract Case: the entire surgery is shown from start to finish, but don’t fret, it is still just a…
Cataract with Silicone Oil Removal
Our guest surgeon is Willie Kan, MBBS from Malaysia and he is showing the technique of combined cataract surgery with…
Simplified Pre-Chop Technique
The pre-chop technique refers to mechanically breaking the nucleus into smaller pieces prior to inserting the phaco probe into the…
Pseudo-Exfoliation White Cataract
Our guest surgeon today is a young ophthalmologist from Spain and he is performing phaco for a patient with a…
Four handed phaco! What?
This is a case where we knew ahead of time there would be issues. The patient is mid 50s in…
Playlist: Hiding in plain sight
There are so many subtle clues in cataract surgery that can easily be missed, particularly when less experienced surgeons are…
Descemet’s Membrane Detachment
When we make a corneal incision for cataract surgery, we must be careful to avoid damaging the attachment of Descemet’s…
Cataract, cornea transplant, glaucoma tube
Our guest surgeon is Guillermo Amescua MD who is a faculty member at the Bascom Palmer Eye Institute in Miami.…
The critical step after the chop
There is a critical step after the chop that is absolutely required to facilitate nucleus removal. And this step is…
Cataract Quiz: First eye predicts the next
This patient had cataract surgery in the first eye a few years ago and when we look at the undilated…
Recovering from an anterior capsule rip
We have extensively covered the topic of white cataracts here on CataractCoach and we have an entire subcategory devoted to…
Recovering from misloaded IOLs
We count on our surgical techs and assistants to help with certain parts of the cataract surgery. One of these…
Playlist: toughest cases of 2020
After reviewing the surgical cases from 2020, I have chosen four tough cases to present here. Two of the cases…
Soft Chop technique for soft cataracts
With the amazing results from modern day cataract surgery, many patients are electing to experience the benefits of pseudophakia when…
Extended Depth of Focus: Alcon Vivity
We all want to be young again, at least when it comes to vision: visual quality, range of vision, and…
Cataract Quiz: Zonular Dehiscence
Our guest surgeon is Dr Willie Kan from Malaysia and he presents a very tough case: a traumatic white cataract…
Severe Zonular Laxity in PXF Cataracts
This is a really difficult surgery and we know that ahead of time. When we examine this patient at the…
Never make an incision like this!
This is a resident case where the incision has terrible construction. The primary mistake is gliding the keratome along the…
chandelier lighting for cataract surgery
This patient has a non-clearing vitreous hemorrhage from proliferative diabetic retinopathy in addition to a cortical cataract. Our guest surgeon…
Playlist: Critical Life Lessons
Let’s start the new year right and make 2021 the time where you advance your surgical skills. Certainly dexterity and…
refractive lens exchange for hyperopia
This 58 year old patient is highly hyperopic, wearing +8.5 D glasses for distance vision and then +11.0 D glasses…
Top CataractCoach videos of 2020
As the year comes to an end, we have succeeded in making a new CataractCoach video/post for every day of…
complete cataract case: optimize steps
Most of us will have the opportunity to perform thousands of cataract surgeries (often tens of thousands) during the course…
clean your optics & focus the microscope
This is actually a very important lesson. Your microscope optics will determine your view for the surgery and that could…
complete case: chop nucleus in the bag
One of my favorite types of videos to watch is the Complete Cataract Case. I enjoy seeing a surgery from…
IOL design differences
We have many different IOL designs available for use in cataract surgery and even within the most popular category (single-piece,…
Playlist: Capsulorhexis
The capsulorhexis is an important step of cataract surgery. It allows us to maintain the strength of the capsular bag…
anterior segment total reconstruction
This is a very complex case of a patient who had cataract surgery elsewhere and sustained complications during the procedure.…
double flange IOL scleral fixation
The Yamane technique of IOL fixation to the scleral works better with certain three-piece IOLs because of the differences in…
management of a dropped nucleus
This is a rare complication that can happen to any patient so the surgeon must know how to effectively manage…
Capsule Break with I/A and rescue
Our guest surgeon today is Dr Ahmed Al Habash who shows us the best technique of dealing with a posterior…
Punctured Posterior Capsule Rescue
There are two types of ophthalmologists who do not ever have surgical complications: those who do not operate and those…
Ruptured Posterior Capsule Recovery
This patient had uneventful cataract surgery in the first eye with placement of a toric trifocal IOL in the capsular…
Playlist: Traumatic Cataract
The eye is a delicate organ and trauma can cause many challenges during cataract surgery. The more common issues include…
Guest surgeon: Milky White Cataract
Our guest surgeon today is Dr Pooja Bhomaj from Miraj, India and she presents a case of a milky white…
This subtle sign indicates weak zonules!
This is a very subtle sign — looking at this title pic, we see a demarcation line just inside the…
Double Phaco Incisions to fix Astigmatism
double phaco incisions for treatment of astigmatism
Benchmark: Skills after 1000 surgeries
Our guest surgeon today is Érico Jun Oda MD from Brazil and he is showing us a routine cataract case.…
This sign means I need a pupil ring
this sign means that I need a pupil ring for cataract surgery
You don’t always need rings or iris hooks
For a case like this, there is no need for a pupil expansion ring or iris hooks. These devices can…
Playlist: Iris Prolapse
Iris prolapse is a relatively common issue in cataract surgery and its management is critical to the success of the…
Complicated Radial Keratotomy Case
This is a tough case where the patient had prior 16-cut radial keratotomy for treatment of a high degree of…
Femtosecond Laser White Cataract
Our guest surgeon today is Xiongfei Liu MD from Sacramento, California. He was previously a resident with us at our…
Complete Case: Pseudo-Exfoliation
Time for a complete cataract case, shown from start to finish. This patient has significant pseudo-exfoliation syndrome with all of…
Phaco tip bevel down for chop
Many viewers of CataractCoach.com ask me why I prefer to have the phaco tip bevel down for cataract surgery. The…
Secret to Chopping a Soft Cataract
If the cataract has a minimal amount of nuclear sclerosis, it is more challenging to chop it. The nucleus is…
Why be afraid of cataract surgery?
why are patients afraid of cataract surgery?
Playlist: Phaco Incisions
The phaco incision is a critical part of the cataract surgery. A great incision is the mark of an accomplished…
Patient moving during cataract surgery
Many patients ask us what will happen if they move during cataract surgery. What if they need to sneeze or…
PanOptix IOL in a Highly Myopic Patient
most extreme PanOptix IOL power for extreme myopia
Fixing IOL-induced UGH Syndrome
UGH syndrome is the triad of uveitis, glaucoma, and hyphema which all can be induced as a complication from sulcus…
Combined Phaco + DMEK Surgery
Descemet Membrane Endothelial Keratoplasty (DMEK) has become the preferred surgical technique for the treatment of Fuchs’ corneal dystrophy. In the…
Cataract Quiz: Why did this happen?
Looking at this picture, the pupil dilation went from 5 mm in diameter to 10 mm in diameter in just…
Rock the Nucleus in White Cataracts
The topic of white cataracts is so popular here on CataractCoach that we have an entire category devoted to it…
Playlist: Complete Cataract Cases
There is so much to be learned by watching a complete surgery, from start to finish. These complete cataract cases…
Twist and Out to Explant IOLs
I first saw Jack Chapman MD explain his technique to explant an IOL at a large ophthalmology meeting about 10…
Fixing a Dislocated IOL
This patient had cataract surgery done elsewhere and now seeks your help for a sub-optimal outcome in the one eye.…
Complete Case: Propagate the Chop
Another video in our Complete Cataract Case series where we show you an entire surgery from start to finish. This…
MSICS in Pseudo-Exfoliation
It is important to learn how to perform MSICS: manual small incision cataract surgery. This is a more evolved and…
Cataract Quiz: Why did the trypan do this?
Cataract Quiz: Why did the trypan blue dye do this? Why is the staining so odd looking? Why is the…
How to dissect the IOL out of the bag
When we are doing an IOL exchange, the first step is to carefully dissect the old IOL out of the…
Playlist: Small Pupil Cataract Surgery
Small pupil cases are relatively common, so all cataract surgeons must learn to master the techniques for these cases. This…
Bad Incisions lead to trouble
This anonymous resident starts the case with a poorly placed and poorly constructed incision. It ends up bleeding, allowing blood…
White Cataract Double Capsulorhexis
It is always a pleasure to learn from a master surgeon like Dr Pradip Mohanta from West Bengal, India. He…
Cataract Quiz: Where is the hidden piece?
Time for another cataract quiz — look carefully at the photo above. Where is the nuclear fragment hiding? And how…
Cataract Quiz: When did the break happen?
This patient has a relatively dense cataract and requires a toric IOL for 2 diopters of regular corneal astigmatism. When…
Cataract Surgery for a Cataract Surgeon
cataract surgeon for a cataract surgeon
Crucial lessons learned in residency
A complication during surgery can be a mistake or it can be a lesson. The difference between them is that…
Playlist: Stop-and-Chop Technique
If you are currently performing the Divide-and-Conquer technique of nuclear division, then moving to the Stop-and-Chop technique is relatively easy.…
Capsular tension rings in PXF
capsular tension rings (CTR) in pseudo-exfoliation (PXF) cataract surgery
Future of IOL calculations: AI
In just 5 minutes this video will show you the future of IOL calculations. Imagine if you met someone who…
Finishing this case will be difficult
The reason why ophthalmologists need to perform at least 1,000 cataract surgeries until they are sufficiently up the learning curve,…
Cataract Quiz: how to rescue this case
This patient has an intumescent white cataract and we know that poses a risk of capsular run-out due to the…
Soft versus Dense Cataracts
Our guest surgeon, Dra. Luz Marina Melo from Colombia, shows us two very different techniques for soft versus dense cataracts.…
Pars Plana Injection of BSS
Our guest surgeon, Dr Mohammad Abusamak from Jordan, is performing cataract surgery on this monocular patient who has a high…
Playlist: Cataract Surgery in Myopia
playlist: cataract surgery in myopia
Cataract Quiz: What should you do?
What are these dark spots seen in the red reflex as you are about to start cataract surgery? What do…
tiny pupil and fibrotic membrane
This is a very tough case for this senior resident. The patient has a history of chronic uveitis, which has…
complete case: phaco chop in myope
Complete Cataract Cases are videos where we show the entire surgery, from the first incision (usually the paracentesis in my…
adherent posterior capsule plaques
You are doing cataract surgery for a patient with a dense nucleus, an advanced cataract, with barely count fingers vision.…
warning: phaco wound burn!
This is among the most important cataract surgery videos that you will see in your lifetime. Really. I have taught…
the bowled out nucleus
We have all experienced it: a nucleus that it too soft and gummy to divide in the capsular bag and…
Playlist: a new feature for learning
a new feature: Playlists to give suggested videos for review
Learning Phaco Chop: you can do it!
Young surgeons need to learn to perform phaco chop — it makes cataract surgery efficient and increases safety. Less ultrasonic…
Cataract Quiz: intumescent decompression
One of our favorite topics on CataractCoach is the intumescent white cataract. We know that the capsular bag is pressurized…
Amazing Pterygium Peeling Technique
After more than 20 years of doing ocular surgery, there are only a few surgical pearls that amaze and surprise…
Small Capsulorhexis Phaco Chop
The capsulorhexis is an important part of cataract surgery and one reason is that it allows access to the inside…
Not all white cataracts are the same
All white cataracts are not the same. They can run the spectrum from soft to very dense, with a variable…
Incisional Techniques for Astigmatism
Cataract surgery can be our most powerful refractive surgery procedure, correcting high degrees of myopia, hyperopia, and even astigmatism (with…
Review: Uveitis, Glaucoma, Cataract
Cataract surgery in an eye with uveitic glaucoma Stepwise approach to surgical success Cataract surgery in eyes with small pupils…
Neo-vascular glaucoma Ahmed Valve FP7
When teaching our UCLA ophthalmology residents at our large county hospital, Olive View UCLA Medical Center, we encounter many patients…
expert white cataract capsulorhexis
CataractCoach has advised the beginning surgeons to improve the dexterity of the non-dominant hand and this case is a great…
a short groove is sufficient
For techniques such as stop-and-chop or divide-and-conquer, the phaco probe is used to sculpt a trench or groove in the…
Complete Cataract Case: Routine Surgery
While it is fun to watch a video of a cataract surgery that involves complicated maneuvers and difficult challenges, this…
Keep track of cortex during surgery
Even with good dilation, cortex can be hidden at the capsular bag equator. In this case, the dilation is about…
choosing refractive targets
Plano is not always the goal It would seem logical that emmetropia is the ideal refractive state of the eye.…
Review: Career Paths for Surgical Learning
The path to learning surgery is a long and challenging one. True success requires years of dedication and the passion…
Cataract Quiz: What happened here?
Our quiz features a video from Gustavo Hüning, MD, MBA from Brazil and it shows an unusual situation that happens…
Rotary Chop Technique
The key to splitting a brunescent cataract is to access the central endo-nucleus. This is the densest part of the…
posterior chamber deepens with capsule break
When the posterior chamber deepens during cataract surgery, it is usually a sign that the posterior capsule has been ruptured.…
Phaco Chop without Vacuum
It is a pleasure to watch an expert surgeon doing cataract surgery and I really enjoyed learning from Dr. Alex…
Cataract Surgery with prior Amblyopia
The most common causes of amblyopia are related to either strabismus or an untreated refractive error, particularly in one eye…
Complete Cataract Case: No pupil ring!
Another video in our series of complete cataract cases, where the entire surgery from start to finish is presented. There…
compilation video: perfecting your surgery
The difference between good and great may appear subtle to outsiders, but for ophthalmologists like us, these details are very…
recovering from Argentinian Flag Sign
We have explained in great detail the techniques that can help to prevent the dreaded Argentinian flag sign with intumescent…
Cataract Quiz: Trapped Air Bubble
We have a great learning case from Dr. Xiaogang Wang from Taiyuan, China with a surgical challenge. This patient has…