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 a pencil on paper. When we are accessing the cataract nucleus, particularly if it is at the iris plane, then the phaco probe is parallel to the iris and this means parallel to the floor of the room. This is necessary to avoid pushing the eye out of primary position and into the nasal canthus (when operating temporally).

This video is another picture-in-picture feature which shows a simultaneous view of the microscope field along with an external, side view of my hands. You can see how I am bracing my hands against the patient’s face, how the instruments are held, and even how my assistant passes me the instruments in a timely and efficient manner. This video is highly educational and may be the most useful in this series of picture-in-picture teaching.

Click below to see a side view of my hands during this cataract surgery:


  1. Great video giving us insight into what’s going on outside the microscope view. Having watched hundreds of your videos I did not appreciate you keep your second instrument in your left hand throughout the case to save reaching for it for the lens insertion and repositioning.

    1. Exactly. You’ll also notice that I palm the fixation ring after making the paracentesis so that I have it ready to go when making the main incision.

  2. hi! thank you for your videos are great. One question for closing the capsulorhexis forcepts wit which fingers do you make force? thumb and middle finder or thumb and index finger.
    thank you

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