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

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

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

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