For 22 years, I did a combination of both private practice as well as academics in which I taught the … More
Category: complete cases
1617: minus power IOLs – meniscus
This patient is so extremely myopic that the IOL power is -2.0 diopters (minus power) in order to leave the … More
1593: this EDOF patient will be amazed
What are the factors for success with EDOF (extended depth of focus) IOLs? How can we ensure that the patient … More
1592: off-axis incisions and toric IOLs
Your surgically induced astigmatism (SIA) from your standard phaco incision is probably far less predictable than you think. There are … More
1591: asteroid hyalosis of the vitreous
We have all seen it before: thousands of small, white, refractile bodies floating in the vitreous cavity with seemingly little … More
1590: flip & chop and clear corneas
This is a complete cataract case, shown start to finish, of a routine cataract surgery using the flip and chop … More
1589: optimzing the incision in RK eyes
The cornea in patients with prior radial keratotomy is very delicate and prone to a higher rate of complications during … More
1566: Ocular Suface & Cataract Surgery
I will be the first to admit that I do not enjoy dealing with ocular surface issues such as dry … More
1565: hesitant to perform flip and chop?
Multiple CataractCoach.com subscribers have emailed me to ask for pearls for success with phaco flip and chop. They have some … More
1564: on-axis incisions for toric IOLs
In most cases, I like to make the phaco incision on the steep meridian of corneal astigmatism. If the patient … More
1563: phaco incision between RK cuts
Radial keratotomy (RK) makes cataract surgery far more challenging. The IOL power calculations are dramatically affected and during surgery we … More
1561: sudden chamber deepening
This patient has a dense cataract and I increased the phaco power in order to help break apart the nucleus. … More
1544: the first chop didn’t work, so…
Enough resident cases for now. If you’re a novice surgeon who has enjoyed learning from the resident cases, you can … More
1522: pupil size affects EDOF IOL vision
As surgeons, we know that the refractive outcome for each patient depends on our surgical technique, the calculations, the technology, … 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
1520: focal traumatic cataract
At the pre-operative consultation for this patient, it was unclear if there was capsular damage associated with this focal opacity. … More
1519: tilt and chop is efficient and safe
This is a complete cataract case, shown start to finish, using the tilt and chop technique. This is like the … More
1508: your last surgery before graduation
After so many years of education and training, you are almost done with your residency / fellowship training. In the … More
1501: complete toric IOL technique
Toric IOLs are great options to address corneal astigmatism, especially when it is 1 diopter or greater in magnitude. This … More
1485: how I know zonular support is weak
Weak zonular support makes cataract surgery far more challenging and increases the potential risks such as vitreous prolapse, retained lens … More
1454: peeling off the pupillary membrane
This patient has a long history of prior uveitis / anterior iritis which caused synechiae where the iris became adherent … More
1453: Quiz: What is your next step?
This is a tough case where the nucleus is very dense and difficult to chop, but the bigger challenge is … More
1451: Quiz: Where is the lens fragment?
A retained lens fragment is common in cataract surgery because we are breaking up the cataract into many smaller pieces … More
1450: pseudo-exfoliation in a 90 year old
Pseudo-exfoliation syndrome means that cataract surgery will be more challenging. The pupil will not dilate as much, the zonular support … More
1449: monocular patient with 16 cut RK
This is a tough case in a patient with just one eye. He had a prior history of 16-cut radial … More
1446: taking pride in your routine surgery
Routine surgery is probably 90% of what you perform every week in your operating room (or operating theatre), but sometimes … More
1445: rubbery brunescent cataract
There is a pleasure in helping patients with a dense brunescent cataract: we enjoy the surgical challenge and the patient … 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
1443: the nucleus just will not rotate
This is a seemingly routine case, shown start to finish, where I find it challenging to rotate the nucleus despite … More
1442: this nucleus is denser than it looks
This is a complete cataract case, shown start to finish, of a patient seen in my private clinic. At the … More
1425: posterior polar or sub-capsular?
Time for you to make the call: you bring the surgical microscope to the eye and just before you start … More
1404: easy pearls for floppy iris cases
So I was at a meeting on the east coast and young surgeons were debating the use of a pupil … More
1393: how to optimize video quality
I frequently get asked how to make the video images better for recording and presenting surgical cases. There are two … More
1376: soft posterior polar cataract
This younger patient has a posterior polar cataract with new PSC (posterior subcapsular) spread of opacities, thereby significantly limiting the … More
1375: cataract with silicone oil droplets
This complete cataract case features a patient who underwent a prior pars plana vitrectomy for a retinal detachment and then … More
1374: how do you remove this spot?
This is a complete cataract case where I find a small central opacity on the posterior capsule. It is on … More
1373: Quiz: what are these opacities?
This is a complete cataract case with a quiz: watch the video (it is brief) and tell me what you … More
1372: my best pearl for Flomax/IFIS cases
This is a complete cataract case shown start to finish in a patient who has floppy iris syndrome due to … More
1354: phaco parameters for efficiency
Surgeons frequently ask me to list my phaco settings for performing efficient cataract surgery. Let me be the first to … More
1353: this means no pupil ring needed
There are some cases where you absolutely need a pupil expansion ring or iris hooks, such as this case. That … More
1343: operate on the steep axis if possible
Some beginning surgeons like to shift the phaco incision in order to maximize their “hand comfort” even if that means … More
1341: phaco in a trabeculectomy eye
Anytime we perform cataract surgery in an eye with prior ocular surgery, there are additional challenges. In eyes with prior … 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
1335: behind the scenes: inside my OR
Surgeons from around the world frequently email me asking to come visit my operating room to watch surgery. In the … More
1320: do I prefer flip or chop?
Many CataractCoach fans have emailed me asking which technique I prefer for routine cases: phaco flip or phaco chop? Some … More
1319: traumatic cataract with iris damage
This patient sustained blunt trauma a few years ago which resulted in a cataract as well as damage to his … More
1318: trifocal IOL performance years later
In the USA we have had access to some trifocal IOLs for the last couple of years. During that time … More
1317: Is a toric IOL ok in Fuchs’ Dys?
We can do cataract surgery for patients with Fuchs’ corneal dystrophy, but we must weigh the relative risks of corneal … More
1312: focus on what is important
After a long day of surgery, I was telling a friend that I felt exhausted. And he remarked that since … More
1311: routine case with moderate density
Don’t be fooled into thinking that there is not much to be learned from watching a routine cataract case. As … More