Case 1. We had an amazing turnout at our Best of Cataract Coach instructional course at the ASCRS meeting in … More
Category: capsule issues
2181: white cataract horizontal chop
Our guest surgeon here is a resident who is doing a great job of horizontal chop in this white cataract. … More
2166: Argentinian flag: how to finish the case
We all are going to experience this complication if we operate on intumescent white cataracts enough: the anterior lens capsule … More
2164: intra-vitreal injection punctures lens
This complications happens more often that we may imagine: the patient receives an intra-vitreal injection for treatment of posterior segment … More
2160: How to save this run-out rhexis?
With an intumescent white cataract the risk of capsular run-out (and Argentinian flag sign) is high and all seasoned cataract … More
2158: How to fix this traumatic cataract?
You cannot fully undo trauma, especially when it comes to the eye and delicate ocular structures. This patient sustained ocular … More
2157: What is going on with that CTR?
Inserting a capsular tension ring (CTR) is not as simple as it sounds. This ring has a spring tension to … More
2139: is the posterior capsule ruptured?
Look carefully at the picture here and ask yourself: what happened and what is the next move? That defect looks … More
2135: do not over-inflate with OVD
What we call viscoelastics are now referred to as OVDs: ophthalmic viscosurgical devices, in some part because we can then … More
2133: surprise true capsular exfoliation
This is a very rare case that I have never encountered in my career: a true capsular exfoliation where there … More
2128: soft white cataract with PC rupture
This patient has a soft white cataract from prior trauma and now it is time for cataract surgery. Look carefully … More
2125: lens punctured during vitrectomy
This patient recently had a pars plana vitrectomy and there was an iatrogenic complication when the vitrector inadvertently punctured the … More
2122: Quiz: Why did the nucleus drop?
Watch this video carefully and we are going to crowd-source the likely reason why this nucleus drops into the vitreous … More
2115: Quiz: What happened with the CTR?
Look carefully at the title photo and let me know what you think is going on with the CTR? What … More
2112: severe anterior capsule phimosis
This patient has severe capsular phimosis which happens where there is weak zonular support and aggressive contraction and fibrosis of … More
2111: white cataract after ruptured globe
This patient sustained a penetrating corneal injury which was repaired surgically with two sutures. Fortunately, this corneal laceration is paracentral … More
2101: posterior polar with split capsule
This is a very tough case where a posterior polar cataract already has a large split in the posterior capsule. … More
2096: and suddenly, the capsule split…
We have all been there: trying to do needle decompression of an intumescent white cataract and then suddenly, the capsule … More
2088: Quiz: Why is this capsule thick and elastic?
This is a different type of CataractQuiz because I am asking you for your help in solving this mystery. Our … More
2083: Quiz: how to manage zonular dialysis?
Look at the picture here and you will see a red reflex indicating a quadrant (or more) of zonular laxity … More
2082: traumatic cataract CTR placement
Our guest surgeon presents a case of a traumatic cataract with zonulopathy. A capsular tension ring is implanted prior to … More
2077: what is an intra-cap cataract surgery?
I received a couple of emails from young surgeons asking to explain the difference between intra-cap, extra-cap, and MSICS cataract … More
2076: run-out rhexis leads to challenges
One of our favorite topics on CataractCoach is the intumescent white cataract. One of the primary difficulties in these cases … More
2070: cataract from electrocution / electric shock
Electrocution is very dangerous and can lead to instant death. In cases where the victim survives, there can be severe … More
2069: how to manage posterior capsule rupture
If you perform cataract surgery, you will need to be able to manage posterior capsule rupture. Even the most experienced … More
2056: IOLs in posterior capsule rupture
Our guest surgeon is Dr Suvira Jain and she runs a great YouTube channel called PhacoPoint where she teaches cataract … More
2051: large capsular bag has more wrinkles
In cataract surgery we are replacing the thick human crystalline lens (4.5 to 5 mm thick) with a thin IOL … More
2046: posterior capsulorhexis runs out
In this case presented here, the patient is quadriplegic and will have great difficulty sitting for a future YAG laser … More
2045: capsule complications from femto phaco
We have extensively covered the topic of using the femtosecond laser to assist in parts of cataract surgery, including studies … More
2041: severe complications with MiLoop
This is a tough situation of intra-operative complications which begin when the lens snare device (miLOOP or MiLoop) in inserted … More
2040: Ahmed segment secured with Gore-tex
This patient presents with a traumatic cataract with extensive zonular loss which means that simply placing an IOL within the … More
2032: ectopia lentis with suture fixation
This is a tough case of ectopia lentis where there is absent zonular support for most of the lens equator. … More
2028: safety suture for CTRs
This video shows a technique of using a safety suture, often a 10-0 prolene or similar, to be able to … More
2024: a resident’s first capsule rupture
All cataract surgeons will experience a posterior capsule rupture many times during the course of a career. This complication is … More
2020: removing calcified lens cortex
This is a very difficult cataract case: the anterior capsule is fibrotic and wrinkled and there is calcified cortex that … More
2019: dislocated IOL, CTR, capsular bag
This patient had cataract surgery years ago and then progressive zonulopathy, such as from pseudo-exfoliation, caused the entire capsular bag … More
2018: dislocated IOL replaced with ACIOL
Looking at this title pic, you can see a large degree of capsular phimosis. This progressive constriction of the capsulorhexis … More
2013: cataract after pars plana vitrectomy
This patient had a pars plana vitrectomy for retinal pathology and then developed this central posterior capsule opacity shortly thereafter. … More
2009: ZeptoLink integrates automated capsulotomy
This is a tough case with a fibrotic anterior lens capsule in a patient who already had capsular complications (and … More
2006: Marfan Syndrome lens dislocation
We have previously featured videos of cataract surgery in patients with Marfan Syndrome, where there is progressive zonulopathy that results … More
2005: pseudo-exfoliation triple surgery
This is a VERY difficult surgery and truly requires expert hands to achieve an excellent outcome. Our guest surgeon does … More
1992: trypan blue behind the capsule
Trypan blue dye can go behind the capsule and stain the vitreous, pool in front of the anterior hyaloid face … More
1990: Quiz: How do you safely finish this case?
Cataract Quiz! As you are doing cortex removal with the IA probe you suddenly notice that the posterior capsule is … More
1983: trauma, hyphema, & iris damage
We know that you cannot undo trauma. No matter how talented the surgeon and no matter the part of the … More
1982: IOL exchange with open capsule
This patient received a light-adjustable lens (LAL from RxSight) and was not happy with the outcome due to both negative … More
1978: recovering from Argentinian flag sign
The challenge with an intumescent white cataract is completing the capsulorhexis without having capsular run-out (Argentinian flag sign). This is … More
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
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