Cataract Surgery with Glaucoma Shunts

Los Angeles is an amazing city which is very diverse and when I am teaching the UCLA ophthalmology residents, we … More

Phaco Incision Size: is smaller always better?

When it comes to incisions in the eye, it would seem that smaller is better. But is that always the … More

The Patient Refuses Refractive Correction!

This 75 year old patient needs cataract surgery because her best corrected vision is 20/50 and it is becoming increasingly … More

Draping is an Important Step of Surgery

Though we don’t often show the process of draping for cataract surgery, it is an important step of the procedure. … More

The Adherent Posterior Capsule Plaque

This patient had a long-standing cataract with a very dense 4+ posterior sub-capsular component. Pre-operative vision was barely counting fingers … More

Removal of a Posterior Capsule Plaque

When we remove the cataractous lens there is sometimes a posterior plaque that is adherent to the capsule. How do … More

Technique for using Diamond Keratomes

Diamond keratomes are my favorite instrument for creating the main phaco incisions because they are exquisitely sharp and they make … More

Particles in the Vitreous during Cataract Surgery

These small particles appeared in the anterior vitreous during what appeared to be a routine and uncomplicated cataract surgery. The … More

Solution for Incomplete Phaco Chops

You’re an experienced phaco chop surgeon and you come across a case where you just cannot get the chop to … More

IOL Power Estimation after Radial Keratotomy

My technician brought the patient to our biometer (Haag-Streit Lenstar) and it simply would not read the corneal power for … More

Cataract Surgery Challenges with Prior Radial Keratotomy

This patient had prior RK (Radial Keratotomy) done a few decades ago for the treatment of myopia. The patient was … More

Cataract Surgery after 20-cut Radial Keratotomy

We have covered the topic of cataract surgery in eyes with prior radial keratotomy (RK) but this case is unusual … More

Some Simple Ophthalmology Mathematics

Ophthalmology has a large degree of math, particularly when it comes to refractive surgery. Our most commonly performed and most … More

Surgically Treating Residual Astigmatism

Which do you choose: Limbal Relaxing Incision (LRI) or Laser Vision Correction (LVC) for treatment of residual astigmatism after cataract … More

Routine Dense White Cataract Surgery

Finishing up our week of routine cataract cases, today we are reviewing dense white cataracts. In some parts of the … More

Routine Phaco Chop Cataract Surgery

Continuing with our series about routine cataract cases, today we present a routine phaco chop surgery. The cataract is chopped … More

Routine Flip-and-Chop Cataract Surgery

We have previously featured an instructional video for the Flip-and-Chop method of cataract surgery and there was a very strong … More

Why I love Routine Cataract Cases

Many of the articles and videos here at CataractCoach.com feature unusual, difficult, or challenging cataract cases. These are fun videos … More

What does the patient actually see?

When we examine patients, we are looking at their eyes and their pathologies from the outside seeing in. We can … More

Bimanual Dexterity Improves Ocular Surgery

I tell my first-year ophthalmology residents to start doing daily tasks such as eating food, shaving, and brushing teeth with … More

Surgical Approach for a Morgagnian Cataract

With a white cataract, typically the cortical layers opacify and may partially liquify, and that can make the surgery more … More

Lost Capsulorhexis – here is the Solution

This patient is having cataract surgery but during capsulorhexis creation, the flap edge seems to get lost. And due to … More

Cortical Spokes blocking the view for Capsulorhexis

In this cataract surgery, which is otherwise routine, the cortical spokes of the cataract are blocking the view right … More

Basics of Limbal Relaxing Incisions (LRIs)

Every incision that is made in the cornea has an effect on its shape and therefore the astigmatism. For a … More

Cataract Surgery after Prior Vitrectomy

Cataract surgery in an eye which has undergone a prior pars plana vitrectomy is different in many ways, including lens … More

Cataract Surgery Learning Grid

During ophthalmology residency, residents are exposed to cataract surgery in steps, starting from the most basic and ending with advanced … More

What I learned about Ophthalmology at age 5

I only remember a few things about kindergarten: playing handball during recess, watching Matilda eat paste, and learning the golden … More

Cataract Surgery in Marfan Syndrome

Patients with Marfan Syndrome have a congenital, progressive weakness in the zonular structures which support the crystalline lens. As such, … More

Temporal vs Superior Phaco Incisions

[Click link below for full video] Some surgeons prefer to make a superior phaco incision while others prefer a temporal … More

Beginning Surgeon Cataract Case Analysis

Becoming proficient at cataract surgery is not easy and the learning curve is quite steep, particularly at the beginning. We … More

How to remove stubborn sub-incisional cortex

During cataract surgery it is important that we remove all of the lens cortex in order to minimize post-operative inflammation … More

Posterior Capsule Rupture & Anterior Vitrectomy

Early in the learning curve of cataract surgery, beginning surgeons end up with a posterior capsule rupture about 5% of … More

Preventing and Treating Capsular Phimosis

The capsular bag contracts when we remove the thick cataract (4+ mm thick) and replace it with a thin IOL … More

CataractCoach.com celebrates 100 articles/videos!

Thank you to all of our readers for their support over the past three months! We have kept up with … More

Cataract Surgery in Small, Hyperopic Eyes

Small eyes make cataract surgery more difficult in many ways: there is less working room in the eye, the IOL … More

Salzmann Nodules and Cataract Surgery

Salzmann nodules occur at the limbus or peripheral cornea and can disrupt the ocular surface, even causing an irregular ocular … More

Ocular Fixation during Capsulorhexis

Sometimes, even with systemic sedation, patients can have a strong Bell’s reflex under topical anesthesia and that makes it difficult … More

Rescuing the Radialized Capsulorhexis

The capsulorhexis is an important early step of cataract surgery because it gives strength to the capsular opening so that … More

Quiz: Persistent Corneal Edema – Why?

This 70 year old patient had successful cataract surgery about one month ago. There were no complications. The patient has … More

YAG Laser Capsulotomy Techniques

Posterior capsule opacification (PCO) is common after cataract surgery. Even a perfect surgery by a master surgeon still leads to … More

Soft Cataract Supra-Capsular Technique

How do you approach a soft cataract, such as a posterior sub-capsular or primarily cortical cataract, with very little nuclear … More

Pre-Chopper Technique for Phaco Surgery

The Pre-Chopper instrument was developed by Takayuki Akahoshi MD from Japan and it allows the cataract nucleus to be divided … More

Soft-Shell Technique for Viscoelastics

The Soft-Shell Technique for viscoelastic use in cataract surgery was developed by Dr. Steve Arshinoff as a method of getting … More

Air Bubbles to Monitor Viscoelastic Retention

Does viscoelastic stay inside the eye when we inject it there to protect the corneal endothelium? Or does it get … More

Dispersive vs. Cohesive Viscoelastics (OVDs)

Viscoelastics, also referred to as OVDs (ophthalmic visco-surgical devices), are viscous substances that allow us to make phaco-emulsification easier and … More

Nucleus Chop with a 27g Cannula

It is the beginning of the academic year, which in the USA runs from July 1 (start) until June 30 … More