This is a resident case where the incision has terrible construction. The primary mistake is gliding the keratome along the … More
Category: Astigmatism
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
Shifting the Phaco Incision to treat Astigmatism
Our phaco incisions always have some degree of astigmatic effect by causing relaxation of the corneal curvature at that axis. … More
One-Chop Technique for Phaco Surgery
For a cataract with moderate nuclear density, splitting the nucleus into two halves can be sufficient for removal with phacoemulsification. … More
The Patient Refuses Refractive Correction!
This 75 year old patient needs cataract surgery because her best corrected vision is 20/50 and it is becoming increasingly … More
Some Simple Ophthalmology Mathematics
Ophthalmology has a large degree of math, particularly when it comes to refractive surgery. Our most commonly performed and most … More
Surgically Treating Residual Astigmatism
Which do you choose: Limbal Relaxing Incision (LRI) or Laser Vision Correction (LVC) for treatment of residual astigmatism after cataract … More
Routine Toric Case with Surgeon-Loaded IOL
Again, time to learn from a routine case — this is the type of case that is your “bread … More
Basics of Limbal Relaxing Incisions (LRIs)
Every incision that is made in the cornea has an effect on its shape and therefore the astigmatism. For a … More
Temporal vs Superior Phaco Incisions
[Click link below for full video] Some surgeons prefer to make a superior phaco incision while others prefer a temporal … More
Cataract Surgery in Keratoconus
Patients with keratoconus, like all patients, eventually develop cataracts. However, cataract surgery in these keratocomic eyes is not the same … More
Choosing Refractive Targets to maximize Depth of Field
From this photo it is obvious that the aperture size of a camera makes a large difference in the depth … More
Complex Cataract: multiple challenging issues
This patient had a large rhegmatogenous retinal detachment repaired a few years ago with a successful pars plana vitrectomy. The … More
Another Corneal Laceration with Traumatic Cataract
Another patient presented to our resident ophthalmology clinic with a 1 day history of doing construction work on a roof … More
Femto Laser Incisions: Good or Bad?
The femtosecond laser is a powerful tool for ophthalmic surgery. While its use in creating corneal refractive surgery is widely … More
Alignment and Centration of Toric Multi-Focal IOLs
[From CataractCoach.com] New technology has given us the ability to address corneal astigmatism and presbyopia with a toric multi-focal IOL. … More
Plano may not be best refractive outcome for every patient
Some patients may benefit from a small degree of residual hyperopia, myopia or astigmatism. There is a pride that we … More
Phaco Incisions can improve or worsen Astigmatism
Astigmatic Effect from Phaco Incision Placement Many patients desire a refractive correction at the same time as cataract surgery. … More
3 Rules for making Phaco Incisions
A well-constructed corneal/limbal phaco incision will improve your cataract surgery technique and provide better results for your patient. (scroll down … More
On-Axis Paired Incisions for Astigmatism
Don’t have a toric IOL? Try this technique to help address astigmatism at the time of cataract surgery.
Phaco Flip and Chop Technique
The phaco flip technique is when the nucleus is prolapsed out of the capsular bag and then emulsified at the … More