A relatively easy solution to address aphakia in patients without capsular support is the iris claw lens which is clipped … More
Category: IOL related
2178: Morgagnian cataract & IOL scaffold
A Morgagnian cataract is where the lens cortex is so liquefied that the remaining cataract endonucleus floats around inside the … More
2156: should you amputate the haptic?
For an IOL exchange, if you cannot free the haptic from the capsular bag due to adhesions, should you amputate … More
2143: easy Visian ICL phakic IOL removal
Phakic IOLs have been very helpful in treating younger patients with high degrees of myopia beyond the capabilities of corneal … More
2142: IOL exchange with UGH syndrome
A single piece acrylic IOL does not work well in the sulcus because of its design: it is planar and … More
2130: Quiz: Why is the IOL iris captured?
Look carefully at this picture and ask yourself why did this happen? The patient had this IOL placed in the … More
2124: IOL exchange and pars plana vitrectomy
This patient complains of “multifocal misery” as well as extensive floaters which can further degrade the image quality. An IOL … More
2123: updated Canabrava technique
We have previously featured the Canabrava technique where an IOL can be fixated to the scleral using segments of 6-0 … More
2118: bilateral IOL exchange
This patient elected to have bilateral cataract surgery with multifocal / trifocal IOLs but then did not like the quality … More
2108: IOL pivot technique using IA probe
Our guest surgeon, Professor Venkatesh presents a technique to easily rotate an IOL both clockwise and counterclockwise with the IA … More
2105: primary piggyback IOL after trauma
Our guest surgeon presents a case of a patient who sustained a penetrating thorn injury to his eye and then … More
2084: modified twist and out IOL explant
We have featured the twist-and-out technique to explant an acrylic IOL through a standard phaco incision using just a spatula … More
2080: technique of using piggback IOLs
Piggyback IOL refers to a second IOL that is placed in the eye so that there are now two lens … More
2068: rotisserie optic tilt with Yamane IOLs
The Yamane technique of IOL fixation to the sclera has become very popular in the last few years but increasingly … More
2066: belt loop with flanges in the cornea
We have seen many techniques of IOL fixation in cases of insufficient capsular support where the flange technique is used … More
2063: the problem of exposed flanges
We have featured many techniques of IOL fixation in cases of insufficient capsular support such as the Yamane technique, the … More
2062: IOL scaffold with Morgagnian cataract
This patient has a Morgagnian cataract where the cortex and epi-nucleus have become liquefied and then partially absorbed, resulting in … More
2042: good job but the patient will not be happy
CataractQuiz™. This anonymous surgeon makes a good incision, a nice capsulorhexis, and then efficiently removes the cataract. The stop-and-chop technique … More
2021: IOL gets entangled with pupil ring
Using a pupil expansion ring, like the Malyugin ring, can be helpful in some cases of a small pupil, but … More
2018: dislocated IOL replaced with ACIOL
Looking at this title pic, you can see a large degree of capsular phimosis. This progressive constriction of the capsulorhexis … More
2012: Gore-tex suture fixation of tilted IOL
This patient was pseudophakic and then sustained ocular trauma which resulted in zonular loss and a tilting of the IOL … More
2010: EDOF IOLs with Radial Keratotomy
Patients with prior radial keratotomy (RK) often have diurnal fluctuations in vision due to changes in the corneal hydration and … More
2004: understanding Aspheric IOLs
Today almost all of the IOLs that we use have an aspheric design with either negative spherical aberration or zero … More
1996: negative spherical aberration IOLs
I have a great educational video about spherical aberration and IOLs that is coming out in the next few weeks. … 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
1974: knot & flange technique to fixate IOL
When I first performed a sutured IOL about 25 years ago, it was suturing a CZ70BD IOL to the sclera … More
1962: effect of pupil size for EDOF IOLs
Just like the aperture (f stop) matters for taking photos with a camera, the pupil size plays a large role … More
1958: haptic disinsertion with Yamane IOL
The Yamane technique of scleral IOL fixation has grown in popularity over the years and it is a good choice … More
1957: challenging opacified IOL exchange
Rarely, IOLs will opacify with time with some designs more prone to this than others. In these cases we need … More
1954: Extended Depth of Focus IOLs
Choose the extended depth of focus IOL that will have best results with fewest compromises. The three main EDOF IOL … More
1921: retro-iris claw lens for aphakia
This patient has a complex ocular history which resulted in an eye with no capsular support. To address the aphakia … More
1898: IOL exchange with open capsule
There are times when an IOL exchange is the best answer for a challenging clinical situation and in this case, … More
1897: Anchor Style haptics for IOL fixation
This patient experienced a dropped nucleus during cataract surgery with extensive damage to the capsular bag. This poses a challenge … More
1863: technique of using Piggyback IOLs
Piggyback IOL refers to a second IOL that is placed in the eye so that there are now two lens … More
1844: ASCRS 2023 Course Case 4
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1803: broken IOL complications
IOLs are delicate and when we roll them and compress them in order to fit through smaller incisions, rarely the … More
1800: dealing with opacified IOLs
There are times when certain hydrophilic acrylic IOLs end up become opaque with time. This is thought to be a … More
1795: IOL exchange is not always the solution
When patients need it, I am a firm believer in IOL exchange. We can go back inside the eye and … More
1794: Eyhance OD and Vivity OS – why?
This patient is a physician from the east coast of the USA (more than 3000 km from my clinic) who … More
1749: Curriculum Lesson 17: IOL delivery
In this next part of our curriculum series, we have lesson 17: IOL delivery. It may sound simple, but injecting … More
1743: measure precisely for Yamane IOLs
Precisely measuring your scleral entry points is critical to center the IOL optic when you are performing Yamane intra-scleral haptic … More
1737: IOL breaks the posterior capsule
We should never devalue cataract surgery or claim that it is such an easy procedure because even in expert hands, … More
1735: Curriculum Lesson 16: IOL loading
Continuing with lesson 16 in our Curriculum series, focusing on IOL loading. Every surgeon must know how to load the … More
1734: the 7L rule saves the day
The 7L rule has been passed down from one generation of ophthalmologists to the next for many decades. It is … More
1677: cataract surgery & phakic IOL removal
This patient had a phakic IOL placed many years ago for the treatment of a high degree of axial myopia. … More
1676: this IOL is going in upside down
The 7L rule makes my life so much easier. This rule states that the leading haptic should look like the … More
1674: IOL choice in a teenager
This young patient presents with dense posterior subcapsular (PSC) cataracts in both eyes which is severely limiting the vision. The … More
1669: Juvene IOL – Grail Study Results
Truly accommodating IOL offers promising results Ophthalmologists have been searching for effective ways to address presbyopia for many decades, particularly … More
1666: IOL exchange for glare, halos
Some patients just cannot tolerate a trifocal IOL design and that is compounded if the refractive target is missed and … 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