1969: Quiz: hole punch sign during phaco

Time for another Cataract Quiz: As you are doing phaco you notice this classic hole punch sign. The groove that … More

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

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

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