1961: review of limbal relaxing incisions

As an ophthalmic surgeon, you promised yourself that you would learn to perform limbal relaxing incisions (LRIs) to help address … More

1750: paired incisions for astigmatism

Doing refractive cataract surgery is becoming the norm with patients desiring correction of refractive errors at the same time as … More

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

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