1830: trust yourself but question computers

I recently performed a cataract surgery case using a heads-up electronic display where the computer would overlay a precise circle … 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

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

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