Time for another Cataract Quiz: As you are doing phaco you notice this classic hole punch sign. The groove that … More
Category: capsule issues
1965: IOL exchange with haptic amputation
All cataract surgeons should learn how to perform and IOL exchange. And we have many videos that show you how … More
1963: inadvertent zonular dehiscence
Iatrogenic complications are tough because we blame ourselves for the sequelae of damaging delicate tissues. In this photo you can … 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
1948: Cataract Quiz: equator, tear, or cortex?
Cataract Quiz: is this the capsular bag equator, a capsular tear, or just cortex?
1937: posterior capsule hydro-polish
Sometimes patients with posterior sub-capsular (PSC) cataracts can have adherent lens opacities stuck on the center of the capsule. This … More
1935: Cataract Quiz: What is your next move?
Study this title picture carefully and look at the tip of the yellow arrow. What is going on here? And … More
1933: cannula punctures posterior capsule
This patient started with an intumescent white cataract and that itself is a challenge. However the real difficulties happened at … More
1930: three very interesting short cases
Today we are featuring three very interesting short cases. The first is performing simultaneous incisions like some famous Brazilian surgeons, … More
1919: converting from phaco to MSICS
All cataract surgeons will encounter cases of posterior capsule rupture during phaco. It is a known complication and can occur … More
1918: surprised by silicone oil during phaco
This patient was referred to this anonymous surgeon for cataract surgery. The patient developed a white cataract shortly after having … More
1909: zonulopathy with capsule fixation
This patient has extensive zonulopathy and phacodonesis which is going to make the cataract surgery difficult and also pose a … More
1906: decentered IOL & fibrosed capsule
This patient underwent cataract surgery a few years prior and now presents to you with a dislocated sulcus IOL and … More
1894: video contest 1st: traumatic cataract
Our first place winner for the video contest presents a very tough traumatic cataract case. This is a case that … More
1892: video contest 3rd: punctured capsule
Looking at the title picture should make you quite a bit uncomfortable because you still have most of the nucleus … More
1878: depot steroid implanted in the lens
This depot steroid device was supposed to be injected into the vitreous cavity, but it ended up inside the crystalline … More
1871: the posterior capsule just ruptured…
It happens to ALL cataract surgeons: the posterior capsule ruptures and there is vitreous prolapse while cataract material is still … More
1848: ASCRS 2023 Course Case 7
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1846: ASCRS 2023 Course Case 6
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1839: posterior polar with capsule rupture
This is a really difficult surgery because it is a posterior polar cataract and there is a pre-existing posterior capsule … More
1825: the problem with one haptic in the sulcus
This patient has femtosecond laser assisted cataract surgery with placement of a trifocal IOL two years ago. And while the … More
1824: two jerky pulls to save the capsulorhexis
We have previously covered the Little Technique to pull backwards to help save a run-out capsulorhexis. This Two Jerky Pulls … More
1823: white cataract after intra-vitreal injection
When a patient develops a white cataract right after an intra-vitreal injection, you can be pretty sure that the capsular … More
1822: lens snare/loop splits the bag!
The idea of a lens snare or loop to mechanically split the nucleus is decades old and we previously discussed … More
1814: My Week: what happened to the capsule?
Just looking at the title picture should give you a little stress — it does for me! In this case, … More
1810: severe zonular loss with Cionni ring
Cases like this are stressful and just looking at this picture should make your heart beat faster. There is a … More
1807: annular cataract with scarred capsule
It is very unusual to see this type of annular cataract where the remaining lens material is in the shape … More
1806: left-handed resident breaks the bag
Let me be the first to say that it is perfectly fine for a surgeon to be left handed. Surprisingly, … More
1799: posterior polar with zonular loss
We know that posterior polar cataract cases are challenging because at the site of the opacity the posterior capsule is … More
1774: When did the posterior capsule rupture?
I have watched this video a few times and I am still not sure when the capsule ruptured. Look at … More
1773: capsule ruptured by intra-vitreal injection
With millions of intra-vitreal injections being performed every year, an iatrogenic rupture of the posterior capsule by the needle is … More
1766: when did the posterior capsule break?
Our guest surgeon, Dr Lukan Mishev, is a highly talented ophthalmologist who is an expert is anterior and posterior segment … More
1751: for capsule wrinkling, I do this…
This is a complete cataract case, shown start to finish, where the anterior lens capsule wrinkles upon attempted puncture for … More
1745: Ahmed capsular segment placement
This is a tough case where the surgeons learns intra-operatively that there is a quadrant of poor zonular support. An … More
1740: dead capsular bag syndrome
In rare cases, years after a cataract surgery, we can have complete loss of zonular support with dislocation of the … More
1739: peeling a posterior polar plaque
We all know that posterior polar cataracts are challenging because at the site of the polar opacity the capsule can … 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
1736:capsule break from OVD bubbles
I was watching cataract surgery videos on YouTube and I saw this video from Dr Shannon Wong from Austin, Texas … More
1730: belt loop to fixate Ahmed segment
This patient sustained ocular trauma which resulted in loss of zonular support for about 180 degrees, allowing tilt and decentration … More
1725: coloboma with capsule rupture
Yesterday we featured a case of cataract surgery in a patient with a coloboma. And today we have another similar … More
1724: coloboma with zonular absence
Today and tomorrow we are featuring cases with congenital colobomas where there is an absence of part of the iris … More
1718: Marfan syndrome subluxed lens
Marfan syndrome patients develop a progressive zonulopathy with subluxation of the crystalline lens which leads to visual decline. While still … More
1712: fibrotic anterior capsule will not tear
This patient sustained ocular trauma which resulted in a white cataract as well as fibrosis of the anterior lens capsule. … More
1711: severe PXF and zonulopathy
This is a very challenging surgery and most surgeons would rate it a 9 or 10 out of 10 in … More
1708: why did this nucleus drop so fast?
This resident case started out pretty well with a good incision and then an intact capsulorhexis, but then things quickly … More
1702: capsule polishing or vacuuming?
Believe it or not, cleaning the undersurface of the anterior lens capsule was not always considered a requirement for a … More
1691: IOL haptic tears posterior capsule
Another tough case today: as this resident implants a three-piece IOL, the leading haptic is twisted and the sharp tip … More
1690: capsule rip extends to posterior capsule
This is a heartbreak of a case. The anterior lens capsule splits wide open with the classic Argentinian Flag Sign … More
1688: post-trab cataract with weak zonule
The most important take home message in this video is when you see the capsulorhexis moving you should immediately think … More
1670: traumatic cataract with iris damage
This patient sustained ocular trauma which resulted in a traumatic cataract, zonular loss, iris avulsion, and vitreous prolapse. Now you … More