I recently performed a cataract surgery case using a heads-up electronic display where the computer would overlay a precise circle … More
Category: capsulorhexis
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
1786: rescuing Argentinian flag sign
What do you do when the anterior capsule tear suddenly extends out to the lens equator? This is the dreaded … More
1785: centrally attached zonular fibers
This is an usual case where there are zonular fibers which are centrally attached onto the anterior lens capsule, so … More
1782: resident week: cystotome rhexis
The simple bent needle, also called a cystotome (or cystitome for the alternate spelling) can be used to create the … More
1765: keep the capsulorhexis centered
In this complete cataract case the pupil has dilated in an asymmetric manner. There is no history of trauma and … More
1764: larger capsulorhexis for larger pupil
This patient has a large anterior segment where the white-to-white diameter is almost 13 mm. He also has a large … More
1755: intumescent cataract double rhexis
Our guest surgeon does a beautiful job with this intumescent white cataract. Because the cortex has liquefied, the capsular bag … More
1715: capsulorhexis right up against iris
For a case like this where the pupil is mid-dilated to about 5 mm in diameter, be sure to make … 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
1710: this radialized capsulorhexis is stuck
This resident is just hitting his/her stride and has done more than 100 cataract surgeries at this point. This started … More
1709: save this run out capsulorhexis
This guest surgeon does a great job of managing this run out capsulorhexis. It extends all the way to the … More
1687: ensuring capsular overlap of optic
In cataract surgery we are taking out a 4 to 5 mm thick human crystalline lens and replacing it with … More
1655: massaging the intumescent lens
The liquefied lens cortex in an intumescent white cataract creates increased pressure within the capsular bag and this can lead … More
1654: this capsulorhexis will radialize
Looking at this picture, the capsulorhexis appears to be proceeding well. It is round and intact and the resident is … More
1653: two cataract surgeons walk into…
It is truly an honor to perform cataract surgery on the eyes of fellow ophthalmologists and I have been blessed … More
1648: cystotome needle decompression
This resident surgeon does a great job on this white cataract case where he performs needle decompression of the intumescent … More
1639: intumescent & pressurized cataract
Increasing lens thickness indicates danger in cataract surgery because liquefied lens cortex can pressurize the capsular bag, increasing the risk … More
1636: capsulorhexis challenges
This video features some challenges that I faced during capsulorhexis creation in seemingly routine cataract cases. Yes, even experts with … More
1609: Curriculum Lesson 7: Capsulorhexis
The capsulorhexis. One of my favorite parts of cataract surgery and one of the hardest steps to learn. When you … More
1579: phaco through small capsulorhexis
The double capsulorhexis technique is very useful for intumescent white cataracts because it allows us to safely decompress the capsular … More
1562: capsulorhexis considerations
As a beginning surgeon, the capsulorhexis is one of the hardest steps of cataract surgery to learn. The anterior capsule … More
1535: resident capsulorhexis rescue
Learning the capsulorhexis is one of the toughest steps of cataract surgery. In this case, a resident surgeon encounters a … More
1523: Zepto for intumescent cataracts
We have seen the videos before where the Argentinian Flag sign develops instantly as the anterior lens capsule splits uncontrollably. … More
1521: when the anterior capsule wrinkles…
Wrinkling of the anterior capsule during the performance of the capsulorhexis can be concerning because it indicates that zonular support … More
1515: expert management of DWC
DWC stands for dense white cataract and in this case, that is exactly what we have. In addition, the anterior … More
1513: white cataract with fibrotic capsule
Our expert surgeon today shows us an approach to a white cataract with a fibrotic anterior lens capsule. This will … More
1465: MSICS: bailout for rhexis runout
MSICS can be a great way to rescue a very difficult case. We recently presented a video of a master … More
1457: small capsulorhexis leads to trouble
This is another case where the capsulorhexis is about 4 mm in diameter and this causes a complication where the … More
1456: operating through a small rhexis
Keep in mind the dimensions of the typical cataractous lens: about 9-10 mm in diameter and then about 4-5 mm … More
1444: the patient moved during the rhexis
As I am performing the capsulorhexis, the patient unexpectedly moved and there is a run-out of the capsule tear. The … More
1436: recover from Argentinian Flag Sign
The complication of uncontrolled splitting of the anterior lens capsule in an intumescent white cataract is something that all cataract … More
1420: cystotome capsulorhexis
Beginning residents are amazed when they see that a complete capsulorhexis can be completed with just a cystotome. Using just … More
1418: advantages of Zepto capsulotomy
There are many ways of performing the steps of cataract surgery. We can do the capsulorhexis / capsulotomy with a … More
1416: capsulorhexis enlargement
There are times when we want to make a small initial capsulorhexis and then enlarge it later to a more … More
1415: white cataract needle decompression
For intumescent white cataracts, it can be helpful to decompress the capsular bag using a needle and aspiration/suction from a … More
1414: white cataract, small capsulorhexis
A small capsulorhexis can pose a big challenge during cataract surgery. Keep in mind that a typical human cataractous crystalline … More
1400: handling the run-out capsulorhexis
The capsulorhexis has a tendency to run-out if the anterior lens capsule is insufficiently flattened, if there is any posterior … More
1389: posterior capsulorhexis optic capture
Our guest surgeon performs cataract surgery for this 5 year old child with galactosemia and he uses pearls learned from … More
1387: Zepto Precision Pulse Capsulotomy
The Zepto device uses a brief pulse of electricity to instantly create a precision capsulotomy in the anterior lens capsule. … More
1362: keratome to start the capsulorhexis
Our guest surgeon has an interesting technique where he uses the keratome to start the capsulorhexis. This saves a step … More
1345: capsulorhexis split – now what?
This patient has a white cataract and this resident is able to perform a successful capsulorhexis after staining with trypan … More
1340: plan your rhexis to avoid opacities
Yesterday’s video (#1339) showed how to move cortical opacities from the path of the capsulorhexis by pushing the liquefied lens … More
1339: you can move cortical spokes
Cortical lens opacities tend to block the red reflex which can make capsulorhexis creation more difficult. Since these cortical spokes … More
1322: femtosecond laser or forceps?
Look carefully at this title photo and tell me which eye had a capsulorhexis with forceps and which eye had … More
1310: why the capsulorhexis matters
The capsulorhexis is a critical step of cataract surgery for two main reasons: it creates a stable and strong opening … More
1303: white cataract double capsulorhexis
This video shows the use of 23g or 25g forceps to create the capsulorhexis via the paracentesis incision. This allows … More
1294: capsulorhexis in a 5 year old child
The lens capsule changes in elasticity over our lives: it is far more elastic in youth than it is in … More
1268: posterior capsulorhexis behind IOL
We have shown previous cases of posterior capsulorhexis here and here and in both this was performed prior to IOL … More
1258: OSN NY managing capsular issues
This talk is one of my lectures from the OSN NY 2021 meeting. This is the Ocular Surgery News meeting … More