Case 1. We had an amazing turnout at our Best of Cataract Coach instructional course at the ASCRS meeting in … More
Category: complications
2164: intra-vitreal injection punctures lens
This complications happens more often that we may imagine: the patient receives an intra-vitreal injection for treatment of posterior segment … More
2160: How to save this run-out rhexis?
With an intumescent white cataract the risk of capsular run-out (and Argentinian flag sign) is high and all seasoned cataract … More
2139: is the posterior capsule ruptured?
Look carefully at the picture here and ask yourself: what happened and what is the next move? That defect looks … More
2135: do not over-inflate with OVD
What we call viscoelastics are now referred to as OVDs: ophthalmic viscosurgical devices, in some part because we can then … More
2128: soft white cataract with PC rupture
This patient has a soft white cataract from prior trauma and now it is time for cataract surgery. Look carefully … More
2125: lens punctured during vitrectomy
This patient recently had a pars plana vitrectomy and there was an iatrogenic complication when the vitrector inadvertently punctured the … More
2122: Quiz: Why did the nucleus drop?
Watch this video carefully and we are going to crowd-source the likely reason why this nucleus drops into the vitreous … More
2115: Quiz: What happened with the CTR?
Look carefully at the title photo and let me know what you think is going on with the CTR? What … More
2100: trauma from a shooting cannula
Our guest surgeon, Dr Lucio Buratto, was featured on our podcast yesterday and he wants to share this video of … More
2096: and suddenly, the capsule split…
We have all been there: trying to do needle decompression of an intumescent white cataract and then suddenly, the capsule … More
2079: Review: Phaco Wound Burns
This is a review video of a topic which we have previously covered. It is critically important, especially for younger … More
2076: run-out rhexis leads to challenges
One of our favorite topics on CataractCoach is the intumescent white cataract. One of the primary difficulties in these cases … More
2069: how to manage posterior capsule rupture
If you perform cataract surgery, you will need to be able to manage posterior capsule rupture. Even the most experienced … More
2056: IOLs in posterior capsule rupture
Our guest surgeon is Dr Suvira Jain and she runs a great YouTube channel called PhacoPoint where she teaches cataract … More
2046: posterior capsulorhexis runs out
In this case presented here, the patient is quadriplegic and will have great difficulty sitting for a future YAG laser … More
2045: capsule complications from femto phaco
We have extensively covered the topic of using the femtosecond laser to assist in parts of cataract surgery, including studies … More
2041: severe complications with MiLoop
This is a tough situation of intra-operative complications which begin when the lens snare device (miLOOP or MiLoop) in inserted … More
2024: a resident’s first capsule rupture
All cataract surgeons will experience a posterior capsule rupture many times during the course of a career. This complication is … More
2021: IOL gets entangled with pupil ring
Using a pupil expansion ring, like the Malyugin ring, can be helpful in some cases of a small pupil, but … More
1982: IOL exchange with open capsule
This patient received a light-adjustable lens (LAL from RxSight) and was not happy with the outcome due to both negative … More
1978: recovering from Argentinian flag sign
The challenge with an intumescent white cataract is completing the capsulorhexis without having capsular run-out (Argentinian flag sign). This is … More
1969: Quiz: hole punch sign during phaco
Time for another Cataract Quiz: As you are doing phaco you notice this classic hole punch sign. The groove that … More
1963: inadvertent zonular dehiscence
Iatrogenic complications are tough because we blame ourselves for the sequelae of damaging delicate tissues. In this photo you can … More
1955: resident misses the Smoke Sign!
You must know what the Smoke Sign is and you must be able to react to it instantly. You can … More
1933: cannula punctures posterior capsule
This patient started with an intumescent white cataract and that itself is a challenge. However the real difficulties happened at … More
1919: converting from phaco to MSICS
All cataract surgeons will encounter cases of posterior capsule rupture during phaco. It is a known complication and can occur … More
1918: surprised by silicone oil during phaco
This patient was referred to this anonymous surgeon for cataract surgery. The patient developed a white cataract shortly after having … More
1893: video contest 2nd: learning from mistakes
Our second place winner in the video contest presents a compilation of complications that were encountered during the journey of … More
1892: video contest 3rd: punctured capsule
Looking at the title picture should make you quite a bit uncomfortable because you still have most of the nucleus … More
1878: depot steroid implanted in the lens
This depot steroid device was supposed to be injected into the vitreous cavity, but it ended up inside the crystalline … More
1871: the posterior capsule just ruptured…
It happens to ALL cataract surgeons: the posterior capsule ruptures and there is vitreous prolapse while cataract material is still … More
1870: three cases of sudden trouble…
In this video we present three cases of sudden trouble: (1) the IOL pops out of the capsular bag, (2) … More
1848: ASCRS 2023 Course Case 7
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1823: white cataract after intra-vitreal injection
When a patient develops a white cataract right after an intra-vitreal injection, you can be pretty sure that the capsular … More
1822: lens snare/loop splits the bag!
The idea of a lens snare or loop to mechanically split the nucleus is decades old and we previously discussed … More
1806: left-handed resident breaks the bag
Let me be the first to say that it is perfectly fine for a surgeon to be left handed. Surprisingly, … More
1803: broken IOL complications
IOLs are delicate and when we roll them and compress them in order to fit through smaller incisions, rarely the … More
1791: Curriculum Lesson 20: complications part 2
More complications to learn from. Remember that no matter how amazing your surgical skills are, you will certainly encounter complications … 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
1777: Curriculum Lesson 19: complications part 1
The next lesson in our CataractCoach Curriculum series is lesson 19: complications, part 1. Every surgeon encounters surgical complications and the key … More
1774: When did the posterior capsule rupture?
I have watched this video a few times and I am still not sure when the capsule ruptured. Look at … More
1766: when did the posterior capsule break?
Our guest surgeon, Dr Lukan Mishev, is a highly talented ophthalmologist who is an expert is anterior and posterior segment … More
1738: sudden choroidal hemorrhage
This is another great example of how even an experienced, expert surgeon can encounter a complication during cataract surgery. This … More
1737: IOL breaks the posterior capsule
We should never devalue cataract surgery or claim that it is such an easy procedure because even in expert hands, … More
1736:capsule break from OVD bubbles
I was watching cataract surgery videos on YouTube and I saw this video from Dr Shannon Wong from Austin, Texas … More
1729: Quiz: what complication is imminent?
Look carefully at the picture and see if you can figure out what complication is imminent. Can you tell what … More
1725: coloboma with capsule rupture
Yesterday we featured a case of cataract surgery in a patient with a coloboma. And today we have another similar … More
1713: pars plana tap for aqueous misdirection
The key to resolving iris prolapse is to release the pressure gradient and we have covered this topic many times … 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