Doing refractive cataract surgery is becoming the norm with patients desiring correction of refractive errors at the same time as … More
Category: Astigmatism
1716: astigmatism in radial keratotomy
For patients with prior radial keratotomy (RK), cataract surgery has to be done differently. These eyes also often have significant … More
1627: follow up from myopia IOL calcs
I trust that you are enjoying our IOL Calc Case Study videos where we go into the details of interesting … More
1602: IOL calc case study 6: high myopia
This patient has a high degree of myopia and also a high degree of corneal astigmatism. The patient wants to … More
1592: off-axis incisions and toric IOLs
Your surgically induced astigmatism (SIA) from your standard phaco incision is probably far less predictable than you think. There are … More
1564: on-axis incisions for toric IOLs
In most cases, I like to make the phaco incision on the steep meridian of corneal astigmatism. If the patient … More
1479: ASCRS case 10: topo & tomography
How do you make a surgical plan to correct astigmatism when the keratometer, topographer, and tomographer show differing degrees and … More
1419: How to reposition a toric IOL
It is now months after the original cataract surgery and you examine your patient and realize that the toric IOL … More
1343: operate on the steep axis if possible
Some beginning surgeons like to shift the phaco incision in order to maximize their “hand comfort” even if that means … More
1259: OSN NY differing astigmatism
This talk is one of my lectures from the OSN NY 2021 meeting. This is the Ocular Surgery News meeting … More
1251: re-aligning a toric IOL without OVD
Our guest surgeon, Dr Alex Abdo Martins from Brazil, has a very interesting case for us. This patient has a … More
1200: small pupil toric IOL case
These are my pearls for implanting a toric IOL and achieving accurate alignment in small pupil cataract cases. These cases … More
1196: newbie guide for toric IOL success
Using a toric IOL is an important skill for an ophthalmology resident to learn. This video gives pearls for learning … More
1170: sealing of paired phaco incisions
Using paired full-thickness incisions to treat corneal astigmatism is an established technique that has been used for many decades. We … More
1084: toric planning for high astigmatism
Our video today showcases the surgical planning for this patient with a high degree of corneal astigmatism. We will go … More
1069: Playlist: Astigmatism
Cataract surgery is designed to correct the cataract. Refractive cataract surgery is to correct the cataract and also the refractive … More
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 … More
Double Phaco Incisions to fix Astigmatism
double phaco incisions for treatment of astigmatism
Incisional Techniques for Astigmatism
Cataract surgery can be our most powerful refractive surgery procedure, correcting high degrees of myopia, hyperopia, and even astigmatism (with … More
choosing refractive targets
Plano is not always the goal It would seem logical that emmetropia is the ideal refractive state of the eye. … More
Cataract surgery & decentered LASIK flap
We frequently have patients with a history of prior LASIK who are now undergoing cataract surgery. We have explained in … More
Quiz: Why are there two main incisions?
Cataract Quiz: Why are there two phaco incisions in this eye? This is a routine cataract surgery and the case … More
Paired Incisions to fix Astigmatism
This is an easy technique that can be so helpful to all cataract surgeons. By using paired phaco incisions, we … More
Review: Cataract surgery after prior RK
This patient was very myopic and desired surgical correction many years before the advent of the excimer laser. As such, … More
Review: Why LRIs should be done at the end
Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract … More
Toric IOL technique with a small pupil
The toric IOL is a great option to address astigmatism at the time of cataract surgery. For the toric IOL … More
Toric IOL Alignment Dilemma
In this picture, all of these lines are at the 120 degree meridian, so how do you choose where to … More
Cataract Quiz: Where should you make the incision?
Our phaco incisions will induce an astigmatic change in the cornea and we can use that to help achieve a … More
Complete Case: Flomax & Toric IOL
Many of our CataractCoach.com readers have been asking for complete cases, shown from start to finish. There is a lot … More
Cataract Surgery with Pterygium Present
For a patient with both a pterygium and a visually significant cataract, the best option is usually to do the … More
Toric IOL planning in a small eye (+29.5 D)
Our main phaco incision will induce astigmatism and multiple variables affect the degree of this change. Larger incisions have more … More
Simplified Technique for LRIs
Limbal relaxing incisions (LRIs) are a great option to treat pre-existing corneal astigmatism at the time of cataract surgery. They … More
Can we use a Toric IOL in Keratoconus?
Toric IOLs have the ability to neutralize corneal astigmatism at the time of cataract surgery to improve vision for our … More
Choosing Toric IOL Steps
For toric IOLs, we need to select the best spherical power as well as the ideal toric step. What is … More
How to do Limbal Relaxing Incisions
Just about any incision in the cornea will induce some astigmatic change. We have shown how to place the phaco … More
Sit temporal but operate using WTR incisions
With-the-rule (WTR) astigmatism is where the steep axis is at or near the 90 degree axis. Placing incisions on the … More
Paired Phaco Incisions to Treat Astigmatism
Cataract surgery is our most powerful refractive procedure based on the spherical power that we can correct. Anything from –30 … More
Toric IOL with intra-operative aberrometer use
Guest Expert John Hovanesian MD implanting a Toric IOL with aberrometer guidance Dr. Hovanesian is a well-known and much respected … More
Review: Temporal vs Superior Phaco Incisions
Some surgeons prefer to make a superior phaco incision while others prefer a temporal approach. Is there a substantial difference … More
Solving a tough case of Hexagonal Keratotomy
Featuring guest surgeon: Arun Gulani MD from Jacksonville, Florida, USA This complex case involved a patient who underwent hexagonal keratotomy … More
For a Dense Cataract should we fix the astigmatism?
This patient has a dense, white cataract with a pre-op vision of just Counting Fingers at 1 meter (CF at … More
Review: 3 Rules for Making Phaco Incisions
Over the last two decades, cataract surgery has evolved from scleral incisions to corneal incisions, from retrobulbar anesthesia to topical … More
Review: Phaco Incision paired with LRI for Astigmatism Correction
We know that the phaco incision will cause some degree of corneal flattening and this has the ability to alter … More
We must Align and Center a Toric Diffractive IOL
With new technology IOLs, we have the ability to address corneal astigmatism as well as provide a wide range of … More
Left-Handed versus Right-Handed with Phaco Incisions
It can be helpful to place our phaco incisions on the steep axis of cornea astigmatism in order to provide … More
Never make your phaco incision like this!
In this anonymous video we have a phaco incision that is very poorly made. The placement is too far from … More
Quiz: Should you implant a Toric IOL in this eye?
The patient is 70 years old and the corneal scar of the left eye is about 80% depth within the … More
This is why I do LRIs at the end of the case
Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract … More
Match the Phaco Incision to the Limbal Relaxing Incision
We know that the phaco incision will cause some degree of corneal flattening and this has the ability to alter … More
Complete Toric IOL Case: from Marking to Alignment
Toric IOLs allow us to surgically treat corneal astigmatism at the time of cataract surgery thereby providing our patients with … More