Review: Chopper protects the capsular bag

We work in a very tiny space of just a fraction of a milliliter: the volume of the anterior chamber … More

Review: Embed the phaco tip without ultrasound

This review is particularly important for ophthalmologists who do cataract surgery for patients with mild to moderate nuclear density. This … More

Pre-Chop Variations for Cataract Surgery

In this video, submitted by Dr. Yaun Lin from Casablanca, Morocco, we can learn multiple different variations of Pre-Chop. This … More

Lens Snare Technique

More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to … More

Review: Why LRIs should be done at the end

Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract … More

Pit Technique for Dense Cataracts

With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult. … More

Complete Case: Soft Cortical Cataract

Another addition to our series on Complete Cataract Cases is this technique for soft cortical cataracts. These cataracts are typically … More

Manual SICS with nucleus bisection

SICS is small incision cataract surgery, and it refers to a method of manual expression of the nucleus through a … More

The Chopper Push Technique

Watch this video carefully and you will see that the chopper instrument is used just once to create a single … More

Epi-Nucleus Flip Technique

With a thick epi-nuclear shell, it is easier to remove it with the phaco probe as compared to the I/A … More

Resident Cataract Case #165 Evaluation

This video is submitted anonymously by a resident ophthalmologist who has completed 164 cataract surgeries so far. This case, his … More

Trap a dense nucleus in order to chop it

With a very dense and fibrous cataract, using just the vacuum from the phaco tip to hold the nucleus is … 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

Phaco Chop in patients over age 90

In previous videos we have explained the differences when operating on nonagenarian patients. These patients have weaker tissues such as … More

Complete Case: Brunescent & White Cataract

This patient truly needs our help. She developed a cataract in the right eye a few years ago and was … More

Review: Side View of Hand Position

While we do hold the phaco probe with a pencil grip, we do not use the same angle as writing with … More

Trouble learning phaco chop? Try this first

One of the main reasons why phaco chop is more difficult to learn than divide-and-conquer is that there is a … More

Checking the IOP at the end of surgery

We want to ensure an appropriate intra-ocular pressure (IOP) at the end of surgery. This puts the eye in a … More

Struggling with Phaco Chop? Let me help you

I will be the first to tell you that mastering phaco chop is not easy, but it is certainly worth … More

How far do you insert the Chopper for Phaco Chop?

A young surgeon who is new to phaco chop asked me how deep to insert the chopper tip into the … More

Highly Efficient Stop-and-Chop

From watching videos here on CataractCoach.com, you’re aware that my favorite method of nucleus division is phaco chop. Any form … More

Flip and Chop in post-PPV eyes

With a prior pars plana vitrectomy, the anterior hyaloid face is gone and therefore there is less support for the … More

Review: External View of Phaco Chop

Most of the videos on this site are taken through the operating microscope. This gives the view of exactly what … More

Do not vacuum near the corneal endothelium

During cataract surgery, you notice a small lens fragment or an air bubble float up to the corneal endothelium, where … More

The chop failed, so I reverted back to this…

The benefit of learning many different phaco techniques is that you can choose the one that is best for each … More

Mastering Divide-and-Conquer Phaco

Back by popular demand! Most beginning surgeons start by learning divide-and-conquer as the primary method of nucleus division for cataract … More

Phaco Chop in the bag with smaller pupils

In many of the prior videos related to smaller pupils, I have emphasized the technique of bringing the nucleus partially … More

Guest Surgeon “Submarine Chop”

We all learn from each other and today’s video is a great example of that. We are learning from Dr. … More

Cataract Surgery prior to Glaucoma Surgery

We know that this patient will be undergoing glaucoma surgery in the near future and you are doing the cataract … More

Review: Learn Horizontal Phaco Chop

The original phaco chop technique described by Dr. Nagahara in 1995 was the horizontal chop. This involves holding the lens … More

Expert Level Divide-and-Conquer

Many surgeons like the divide-and-conquer technique and it is widely used here in the USA. For young surgeons, it is … 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

How to sculpt a nuclear groove

Sculpting a groove in the nucleus is required for techniques such as divide-and-conquer and stop-and-chop. The groove works best when … More

Guest Surgeon: Phaco Chop Technique

This video was anonymously submitted by an experienced surgeon who wants us to analyze the phaco chop technique and give … More

Cataract surgery in Nanophthalmos

Nanophthalmic eyes are very small with a short axial length of less than 20 mm. This makes the cataract surgery … More

Pre-Chopper Phaco Technique

There are many different ways to divide the nucleus during cataract surgery. Phaco of smaller nuclear fragments is easier and … More

CTR Technique with less capsular stress

We have featured prior videos about insertion of capsular tension rings (CTRs) during cataract surgery. These devices can be very … More

When should we leave “good enough” alone?

When should we leave “good enough” alone? Ophthalmologists tend to be perfectionists in nature and I certainly fit that description. … More

Sit temporal but operate using WTR incisions

With-the-rule (WTR) astigmatism is where the steep axis is at or near the 90 degree axis. Placing incisions on the … More

Secrets to Avoid Corneal Edema after Cataract Surgery

Corneal edema can occur after cataract surgery due to a number of factors such as a higher degree of ultrasonic … More

Use the Chopper to Lift Nuclear Pieces Up

In cases where the capsulorhexis is small or where the nucleus is particularly large, it can be difficult to bring … More

Learn the Pupil Stretch Technique

Stretching the pupil during cataract surgery is a safe and effective way to improve access via mechanical dilation. While there … More

Review: Embed the phaco probe without ultrasound

The classic teaching for phaco chop and quadrant removal is to embed the phaco probe into the nuclear piece by … More

Guest Surgeon Efficient Divide-and-Conquer

After thousands of cases, surgeons become very efficient and can complete cataract procedures with fewer instruments and less surgical trauma. … More

Surgical Approach to a Traumatic Cataract

When we are faced with a traumatic cataract, there are many factors to consider. The easiest issue is the lens … More

Phaco Chop without using the phaco probe

This is a cataract surgery performed by a resident in training and the patient is known to have Fuchs’ corneal … More

Analyzing a resident Stop-and-Chop case

Most of the uncut surgical videos that are shown here are very efficient and complete cases can be performed in … More

Quiz: For a pupil like this, what is your approach?

With time, young ophthalmologists develop surgical judgment and they are able to look at a case and decide what approach … More

Cataract Surgery using a Scleral Tunnel Incision

Twenty years ago, when I did my residency training at the Jules Stein Eye Institute at the UCLA School of … More