The capsulorhexis is an important part of cataract surgery and one reason is that it allows access to the inside … More
Category: capsulorhexis
Not all white cataracts are the same
All white cataracts are not the same. They can run the spectrum from soft to very dense, with a variable … More
expert white cataract capsulorhexis
CataractCoach has advised the beginning surgeons to improve the dexterity of the non-dominant hand and this case is a great … More
recovering from Argentinian Flag Sign
We have explained in great detail the techniques that can help to prevent the dreaded Argentinian flag sign with intumescent … More
measure the capsulorhexis in high myopia
Eyes come in a spectrum of sizes, particularly with the measurements of the anterior segment in patients with extreme refractive … More
Challenge: Monocular Dense Cataract
Operating on a monocular patient is always stressful since we know that the stakes are higher due to the patient … More
Intumescent Cataract Auto Aspiration
We know that intumescent white cataracts can be challenging because the lens capsule is pressurized with liquefied lens cortex. This … More
Capsulorhexis Pearls
By watching many surgeons, we can learn different ways of performing the same procedure. In this case, Dr Luis Escaf … More
Complete Case: Pressurized Cataract
This is an interesting case of a young patient, in his mid 40s, who sustained ocular trauma and developed a … More
Cataract Quiz: Use the can-opener now?
During capsulorhexis creation, this resident surgeon loses control of the anterior capsule edge and it runs all the way out … More
Learn as I coach this resident
Many ophthalmologists from around the world have asked if we offer a fellowship, externship, or clinical rotation so that they … More
Spiral Capsulorhexis Technique
After needle decompression of the cataract, using a spiral technique for the capsulorhexis has a distinct advantage: if there is … More
White cataract needle decompression
We know that an intumescent white cataract is fluid-filled with liquefied lens cortex. This makes the pressure within the capsular … More
Wrinkled and fibrotic lens capsule
This seemed like a typical white cataract during the pre-operative exam and when first placed under the surgical microscope on … More
Cataract Quiz: Argentinian Flag Sign
Cataract Quiz: How can you prevent the dreaded Argentinian flag sign now? White cataracts can pose a challenge when performing … More
Review: Double Capsulorhexis for White Cataracts
Intumescent white cataracts pose a challenge because the lens cortex has degenerated so much that is has liquefied. This creates … More
Quiz: What is different about this cataract?
Look carefully at the picture above and you will see something that is different about this white cataract. It is … More
Review: capsule attachments with femto-laser
This young patient (about 40 years old), developed a white cataract which has severely impaired vision in this eye for … More
Cataract Quiz: Why shift the capsulorhexis?
Looking at the picture above it seems like the capsulorhexis has been shifted nasally: it is much closer to the … More
Use Trypan Blue dye before OVD
Trypan Blue dye is very useful in cataract surgery because it can stain the anterior lens capsule which improves visualization … More
Enlarge the Capsulorhexis
A small capsulorhexis makes nucleus removal more difficult, especially when we have a dense cataract. When the entire lens hardens … More
Recovering from Argentinian Flag Sign
We have an entire section devoted to achieving success with white cataracts, including intumescent white cataracts. But even in expert … More
Cataract Quiz: Which direction for capsulorhexis?
In this Cataract Quiz we have a patient with a white cataract and as we start to tear the capsulorhexis, … More
Fixate the eye with your other hand
The problem with using two hands to hold the capsulorhexis forceps is that you lose the ability to have the … More
Capsulorhexis forceps with ruler marks
Our guest surgeon is Dr. Ron J. Smith who has been instrumental in teaching cataract surgery at UCLA for the … More
Cataract Quiz: Rescue this Rhexis!
For this Cataract Quiz we have guest surgeon Dr. Naveen Gopal from Bangalore, India showing us a tough case that … More
Do not make a baby capsulorhexis
Making small capsulorhexis makes the cataract surgery more difficult because it limits access to the capsular bag and makes it … More
How to Enlarge a Small Capsulorhexis
Making a small capsulorhexis can make the cataract surgery more difficult. It becomes challenging to bring nuclear pieces out of … More
Capsulorhexis Pivoting
The key to making a great capsulorhexis is understanding the pivoting technique. This allows us to float within the incision … More
Capsulorhexis: Good vs Great
In this picture, the capsulorhexis on the left is good because it is centered, continuous, and an appropriate size, but … More
How to Rescue this Capsulorhexis
We have previously discussed the Little Maneuver which is a method of saving a run away capsulorhexis. In this case, … More
Refining your Surgical Signature
It is so important for surgeons to take pride in their work. You must do a great job, or don’t … More
Review: Posterior Capsulorhexis Technique
If there is a central posterior capsule plaque that cannot be removed with the suction from the irrigation/aspiration probe, we … More
Review: External View of Cataract Surgery Steps
Two of the most critical steps in cataract surgery are the main phaco incision and the capsulorhexis. Properly completing these … More
The Smallest Permissible Capsulorhexis
From watching our videos, you know that for most cases, I find that a 5 mm capsulorhexis is ideal. This … More
Two-Handed Capsulorhexis Technique
Our guest surgeon is Ravi Goel MD from New Jersey, USA who is also the author of the ProtectingSight.com blog. … More
Recovering from a radialized capsulorhexis
Learning to perform a consistent capsulorhexis is one of the toughest steps of cataract surgery. The anterior capsule is only … More
What can we learn from the first eye cataract surgery?
The patient had cataract surgery of the right eye two years ago. Initially, she had a plano outcome and great … More
Spiral Out Capsulorhexis for Intumescent Cataracts
Some white cataracts are intumescent which means that the capsular bag is filled with liquefied lens cortex. This fluid increases … More
Review: 12 Consecutive Capsulorhexes
Seeing the same step of surgery performed over and over again can help beginning surgeons learn the subtleties of the … More
Tear Out of the Anterior Capsule
In this video, which was anonymously submitted, an experienced surgeon encounters a routine cataract case where the anterior capsule is … More
White Cataract with Fibrotic Lens Capsule
This video was submitted by an anonymous surgeon who is attempting this case early in the course of surgical training. … More
Quiz: Cataract & Penetrating Corneal Injury
This patient had a penetrating corneal injury many years ago. When we look at the eye we can see evidence … More
Review: 1 or 2 hands for the capsulorhexis?
The capsulorhexis is one of the most important and most challenging steps of cataract surgery. When you are performing the … More
Quiz: What does this sign mean?
You are just about to start the capsulorhexis and you notice that the anterior lens capsule has straie emanating radially … More
Capsulorhexis with an anterior capsular plaque
This anterior capsular plaque makes the capsulorhexis creation more challenging. The capsule will not tear predictably in the region of … More
I/A probe going under the cortex
Most of the time, we grab the cortex edge under the anterior capsular rim and then we strip centrally. But … More
Challenges with a smaller capsulorhexis
What are the challenges with a somewhat smaller capsulorhexis? In most of my cataract cases, I try to make a … More
Does Capsulorhexis direction matter?
Does it matter which way you perform the capsulorhexis? Clockwise or counterclockwise, which is better? What about for right handed … More
Capsulorhexis technique with just forceps
In more than 99% of my cataract surgery cases, I do not use a cystotome to start the capsulorhexis. I … More