With a dense brunescent cataract, the beauty of MSICS is that no ultrasonic energy is needed to break apart the … More
Category: brunescent cataract
1845: ASCRS 2023 Course Case 5
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1768: brunescent dense rock cataract
This is a tough case and when you see the microscope lights turned up but still no red reflex, you … More
1686: dense cataract iris & zonular loss
This case is beyond 10 out of 10 in difficulty and our guest surgeon, Dr Steve Safran, is a true … More
1645: phacolytic glaucoma & synechiae
Our guest surgeon does a great job with a very difficult cataract surgery. The patient has phacolytic glaucoma where the … More
1516: ultra dense black cataract
Our guest surgeon is an amazing surgeon, Dr Neto Rosatelli from Brazil. He presents a very, very dense cataract in … More
1514: “the toughest case of my life”
“The toughest case of my life” is quite a statement when it is said by a highly experienced, expert level … More
1476: ASCRS case 7: dense cataract tricks
Another great case from the 2022 ASCRS CataractCoach instructional course, this time focusing on dense cataracts. There are some good … More
1453: Quiz: What is your next step?
This is a tough case where the nucleus is very dense and difficult to chop, but the bigger challenge is … More
1445: rubbery brunescent cataract
There is a pleasure in helping patients with a dense brunescent cataract: we enjoy the surgical challenge and the patient … More
1441: converting from phaco to MSICS
Our guest surgeon is Jack Shao MD who is a faculty member at the Cole Eye Institute at the Cleveland … More
1301: dense cataract divide and conquer
The divide and conquer technique is a tried and true method for nucleo-fractis. It works well in a variety of … More
1239: dense brunescent cataract
This patient has a very dense, brunscent, fibrous cataract in the left eye. Fortunately, the right eye has a moderate … More
1155: dense cataract, small pupil, MIGS
This is a tough case in an 87 year old patient who has a small pupil, a dense cataract, and … More
1124: Pearls for learning MSICS
It may surprise you to know that many young ophthalmologists in the USA do not have experience performing MSICS. In … More
1123: dense brunescent cataract chop
This video showcases the entire surgery which we are running at 2x speed so that it is just 5 minutes. … More
1091: Dense Cataract and Nystagmus
Our guest surgeon is Dr Érico Jun Oda from Brazil and he demonstrates an expert level cataract surgery in a … More
1079: you must learn SICS / ECCE
More than 20 years ago when I was a resident ophthalmologist at the UCLA Jules Stein Eye Institute, we performed … More
1008: Horizontal Chop Technique
Our guest surgeon is Dr Hafidi Zouheir from Rabat, Morocco and he expertly demonstrates the horizontal chop technique for a … More
Rotary Chop Technique
The key to splitting a brunescent cataract is to access the central endo-nucleus. This is the densest part of the … More
Expert Surgeon versus The Rock
There is so much to be learned by watching other surgeons operate. Even after so many thousands of cataract surgeries … More
You must learn to do MSICS
In many countries where dense, brunescent cataracts are common, the SICS (small incision cataract surgery) or MSICS (manual small incision … More
Submarine Chop for dense cataracts
For a dense cataract, performing phaco chop is challenging because the central lens nucleus is so hard that the chop … More
Bilateral brunescent cataract surgery
This patient has been functionally blind for 10 years and presents to us with bilateral, dense, brunescent cataracts. We must … More
Lens Snare Technique
More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to … More
Pit Technique for Dense Cataracts
With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult. … More
Trap a dense nucleus in order to chop it
With a very dense and fibrous cataract, using just the vacuum from the phaco tip to hold the nucleus is … More
Complete Case: Brunescent & White Cataract
This patient truly needs our help. She developed a cataract in the right eye a few years ago and was … More
Cataract Surgery in a 100-year-old patient
We should all be so lucky to live to 100 years old. It’s quite a rarity and it is something … More
The Chop will not propagate through the cataract
With a dense cataract, a fibrous posterior plate can develop within the lens nucleus. This makes is challenging to split … More
Dense Morgagnian Cataract with Capsule Break
With a Morgagnian cataract, the entire cortex becomes liquified and then the remaining lens nucleus floats within this fluid. In … More
Review: Solution for the Dense Nuclear Posterior Plate
Looking at this image should intimidate beginning cataract surgeons: this is a whitish-brown totally opaque cataract and it is a … More
Guest Surgeon: Cataract with Fibrotic Anterior Capsule
In rare cataract cases, particularly those from prior trauma, we can get fibrosis of the anterior capsule. This makes the … More
Review: Multiple Small Chops for a Dense Cataract
In previous videos, I have shown my technique for breaking up a dense brunescent cataract with a fibrous and tough … More
Review: Cracking the Posterior Plate in a Dense Cataract
With a dense brunescent cataract, one of the primary challenges is cracking the fibrous posterior plate of the nucleus. Using … More
Small Pupil, Dense Cataract, Corneal Scar, Glaucoma
The key to approaching a difficult surgery is to use a stepwise approach. In the case presented here, we have … More
Wrinkled Anterior Lens Capsule – be careful!
poor zonular support cataract surgery
Use Multiple Small Chops for a Brunescent Cataract
In previous videos, I have shown my technique for breaking up a dense brunescent cataract with a fibrous and tough … More
Cracking the Posterior Plate in a Dense Cataract
With a dense brunescent cataract, one of the primary challenges is cracking the fibrous posterior plate of the nucleus. Using … More
Novice Surgeon attempts a Dense Brunescent Cataract
Today we feature a brave and talented young surgeon who has only about 30 cataracts of experience so far. And … More
Why did we get a Phaco Wound Burn?
The cornea is a very delicate tissue: it’s thin, clear, avascular, and susceptible to damage, particularly from the heat that … More
White Cataract: Solution for the Dense Posterior Nuclear Plate
Looking at this image should intimidate beginning cataract surgeons: this is a whitish-brown totally opaque cataract and it is a … More
Older Surgical Techniques Still Matter
Yes, I love phaco too, but we should all learn to do SICS as well. (Classic ECCE teaching video below) This … More
Approach to the Dense Brunescent Cataract
With Increased Nuclear Density comes Increased Risks Here is how to successfully approach these tough cataract surgery cases: Patients with … More