This is a tough situation of intra-operative complications which begin when the lens snare device (miLOOP or MiLoop) in inserted … More
Category: complications
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
1708: why did this nucleus drop so fast?
This resident case started out pretty well with a good incision and then an intact capsulorhexis, but then things quickly … More
1705: recovering from iatrogenic iris damage
This is a very tough case and the iris prolapse and damage is considerable. This is the type of case … More
1691: IOL haptic tears posterior capsule
Another tough case today: as this resident implants a three-piece IOL, the leading haptic is twisted and the sharp tip … More
1690: capsule rip extends to posterior capsule
This is a heartbreak of a case. The anterior lens capsule splits wide open with the classic Argentinian Flag Sign … More
1686: dense cataract iris & zonular loss
This case is beyond 10 out of 10 in difficulty and our guest surgeon, Dr Steve Safran, is a true … More
1649: phaco wound burns
This video is critically important, especially for younger surgeons, because a phaco wound burn is a complication that happens more … More
1612: retrieval of a lost CTR
When implanting a capsular tension ring, particularly in a challenging case, there is always that tiny fear that it may … More
1605: learn the ominous snap sign!
If you only watch one CataractCoach video this month, this is the one I encourage you to study very carefully. … More
1604: return to the OR for retained lens
A retained lens fragment is a relatively common occurrence after modern day cataract surgery. We are able to use small … More
1599: leaky paracentesis causes issues
You may think that a paracentesis incision is trivial and has little effect on the case, but that is not … More
1578: how to rescue this capsule split
You are performing cataract surgery and everything appears routine as the case is progressing smoothly. The nucleus is removed and … 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
1507: the main incision rips – now what?
What would you do if the main phaco incision ripped during your procedure? This will certainly cause a fluidic imbalance … More
1490: large Descemet detachment
We all know how delicate the Descemet layer of the cornea is and also how easily it is damaged. Even … More
1489: corneal epithelial bubble
This patient developed a corneal epithelial bubble during cataract surgery. Why did this happen and what should you do now? … More
1482: upside down IOL – who is at fault?
Watch this anonymous video very carefully and let me know who is to blame for this upside down IOL, the … More
1478: ASCRS case 9: upside down IOL
You may be surprised to learn that an upside down IOL happens to every single cataract surgeon. The key is … More