Pre-chopping the nucleus means that we are splitting it into quadrants prior to placing the phaco probe in the eye. … More
Category: Cataract Surgery Techniques
2140: temporal MSICS for white cataract
Our international CataractCoach fans may be surprised to learn that the vast majority of USA cataract surgeons do not know … More
2116: cortical cleaving hydro-dissection
Cortical cleaving hydro-dissection was described 30 years ago by Howard Fine MD, a pioneer in the shift to modern day … More
2104: understanding vertical chop
The most common request from CataractCoach fans is guidance for learning phaco chop. Yes, your divide and conquer and your … More
2103: understanding horizontal chop
The most common request from CataractCoach fans is guidance for learning phaco chop. Yes, your divide and conquer and your … More
2098: is anterior polar cataract different?
We have many videos about posterior polar cataracts because those are very prone to complications unless specialized techniques are used … More
2090: mastering stop and chop phaco
The stop-and-chop technique of cataract surgery is a great technique for phaco because it combines the benefits of divide-and-conquer with … More
2089: mastering divide and conquer
The divide-and-conquer technique of cataract surgery is tried and true and it is the first nucleo-fractis technique that we teach … More
2087: opaque but mushy, so tilt and tumble
This is another case featuring the tilt and tumble technique described years ago by Dr Dick Lindstrom. This patient has … More
2086: too mushy, so do tilt and tumble
This is a complete cataract case featuring a nucleus that is too mushy to chop, so I revert to the … More
2081: slow motion of extreme efficiency
Like you, I love learning from other surgeons, and I am indebted to many outstanding colleagues around the world. Ophthalmologists … More
2077: what is an intra-cap cataract surgery?
I received a couple of emails from young surgeons asking to explain the difference between intra-cap, extra-cap, and MSICS cataract … More
2058: cracking the leathery posterior plate
With a dense, brunescent cataract the posterior aspect of the nucleus becomes tough and leathery. Traditional chopping methods usually are … More
2054: carousel technique of nucleus removal
Our guest surgeon presents a case that shows excellent knowledge of intra-ocular fluidics. By aspirating the cataract edge a rotation … More
2026: using phaco vacuum to lift nucleus
I have often advocated the use of the flip and chop technique whereby part of the lens equator is brought … More
1995: tilting the nucleus makes chop easy
Some surgeons desire to learn variations of phaco chop but they are uncomfortable with placing the chopper around the lens … More
1985: needle decompression technique
Intumescent white cataracts have liquefied lens cortex which creates a high intra-lenticular pressure and this causes a force on the … More
1984: IOL scaffold technique
We have featured the IOL scaffold technique before in cases where there is a posterior capsule rupture and the optic … More
1979: MSICS in cases with softer cataract
There is no doubt that MSICS is a great procedure for a dense, brunescent, rock hard cataract. MSICS stands for … More
1916: The 8-Chop Technique – Pre-Chop
Some surgeons love the pre-chopper because it allows for efficient splitting of a nucleus, usually into quadrants. This surgeon takes … More
1880: pre-chopper makes surgery easier
The pre-chopper was popularized by Prof Akahoshi from Japan and it was designed to mechanically chop the nucleus into quadrants … More
1864: single incision phaco surgery
Our guest surgeon performs this routine cataract surgery with just one incision. There is no paracentesis incision and therefore no … More
1853: understanding the combo chop
This combo chop is a mix of horizontal and vertical chop and it has become my go-to technique for phaco … More
1834: phaco-section and then extraction
We have previously featured this technique (and this guest surgeon) which shows the phaco-section technique. In this case, using a … More
1824: two jerky pulls to save the capsulorhexis
We have previously covered the Little Technique to pull backwards to help save a run-out capsulorhexis. This Two Jerky Pulls … More
1815: My Week: do not prolapse this nucleus
For many cases, I prefer to partially prolapse the nucleus out of the capsular bag so that it is easier … More
1719: Crater Chop Technique
This resident cataract surgery case shows the crater chop technique where a central section of the nucleus is bowled out … More
1706: Approach to the Gummy Nucleus
This patient has a large cortical opacity in the central visual axis which is distorting the vision tremendously. So while … More
1695: why I am doing stop and chop?
If phaco chop is so amazing, then why am I doing stop and chop in this case? Answer is in … More
1692: tailor your technique to your population
I am a strong advocate of learning all different techniques of phaco and nucleo-fractis because I want to have all … More
1687: ensuring capsular overlap of optic
In cataract surgery we are taking out a 4 to 5 mm thick human crystalline lens and replacing it with … More
1682: what is your approach to chemosis?
Chemosis. It happens to all of us. Just a slight cut of the conjunctiva and the balanced salt solution will … More
1673: lift the iris in a small pupil case
For patients with smaller pupils, such as this case with about a 4 mm pupil diameter, I tend not to … More
1661: X-NIT simplifies Yamane IOL fixation
Our guest surgeon has developed a novel technique for simplifying the Yamane IOL scleral fixation procedure. Typically with the Yamane … More
1632: sphincterotomy & bag handle
The two techniques shown in this video have not been previously featured on CataractCoach and since they are from the … More
1621: is it ok to do phaco in the AC?
Many years ago when phaco techniques were first being developed, some surgeons elected to do phaco in the anterior chamber. … More
1601: cataract skills after 1600 cases
Yesterday was video number 1600 which means that we have featured a new video/post every day for the past 1600 … More
1596: resident divide and conquer
While I prefer variations of phaco chop for most of my cataract surgery cases, residents typically start learning cataract surgery … More
1580: phaco surgeon does great MSICS
Our guest surgeon is a very experienced cataract surgeon and an expert at phaco, but he has decided to perform … More
1576: three techniques of nucleus division
Our guest surgeon today is a young resident from Brazil who sent in a video showing him performing three different … More
1531: what happened to bimanual phaco?
Many of our surgeons use bimanual irrigation/aspiration during cataract surgery and certainly all retina surgeons perform bimanual vitrectomy, so what … More
1523: Zepto for intumescent cataracts
We have seen the videos before where the Argentinian Flag sign develops instantly as the anterior lens capsule splits uncontrollably. … More
1505: single-handed phaco technique
A generation ago, the most common technique for phaco cataract surgery was to use a single incision and a single-hand … More
1495: another resident stop-and-chop
This is case number 22 for a beginning surgeon who is learning stop-and-chop. If this newbie can learn this technique, … More
1494: resident stop-and-chop review
This anonymous resident is performing case number 128 of her/his career using the stop-and-chop technique. If you are a surgeon … More
1493: stop-and-chop technique
Our guest surgeon does a beautiful job demonstrating the stop-and-chop phaco technique. We have featured this technique many times before … More
1402: phaco-section in MSICS
We have already explained the benefits of learning MSICS (manual small-incision cataract surgery) and I always encourage my USA colleagues … More
1401: nucleus division with weak zonules
Our guest surgeon shows two techniques that can be useful in cases where the zonular support is weak. There is … More
1382: hyper mature cataract MSICS
In an eye with a truly dense, hyper-mature cataract, MSICS (manual small incision cataract surgery) can be a better option … More
1370: video contest PLUS bonus video
First let me tell you about the amazing bonus clip that is at the end of this video — it … More