All this week we are featuring cases of MSICS: manual small incision cataract surgery. The incision is not all that … More
Category: corneal issues / dystrophies
1843: ASCRS 2023 Course Case 3
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1811: triple procedure: PKP + CEIOL
The term triple procedure is a little misleading because it is two surgeries: corneal transplantation and cataract surgery. The triple … More
1744: keratoglobus cataract surgery
Keratoglobus is a rare condition, so rare that I have never seen a patient with this condition in my career, … More
1723: Quiz: Why did corneal edema develop?
Quiz time with another CataractQuiz™ from CataractCoach™. Look carefully at the photo above and you will note that the patient … More
1698: phaco trabeculectomy with leukoma
This is a very tough case because the patient has a long-standing corneal scar, a cataract, and glaucoma that is … More
1684: displaced phakic IOL & endo loss
This patient had bilateral phakic IOLs implanted about a year ago to address a high degree of myopia. Now the … More
1615: micro-cornea and coloboma
This is a very unusual case where the patient has a micro-cornea and also a coloboma with associated zonular absence … More
1582: Quiz: Why such an odd chopper?
Time for a Cataract Quiz: look at the picture here and tell me, why this surgeon is using such an … 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
1559: MSICS for weak K endothelium
Doing phacoemulsification surgery involves using ultrasonic energy and fluidic flow to break up and aspirate the cataract nucleus. Both the … More
1528: open globe, failed graft, & cataract
This video is a series of three separate surgeries on the same patient, by the same surgeon, Dr Jimmy Hu … More
1509: DMEK transplant wipe technique
I enjoy learning new techniques and I am honored to have learned DMEK pearls from the true experts like Martin … 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
1488: Fuchs Dystrophy with EDOF IOL
In the past, I was reluctant to implant an EDOF (extended depth of focus) IOL in patients with corneal issues. … More
1479: ASCRS case 10: topo & tomography
How do you make a surgical plan to correct astigmatism when the keratometer, topographer, and tomographer show differing degrees and … More
1470: ASCRS case 1: what happens next?
At the 2022 ASCRS meeting in Washington, DC, we hosted a CataractCoach instructional course and it was a huge success. … More
1469: open sky cataract surgery
There are times where you will want to perform a combination surgery of full-thickness corneal transplant and cataract surgery at … 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
1413: ruptured globe cases x 2
This resident surgeon had a busy night on call with two ruptured globe cases presenting to the emergency department. The … More
1383: Descemet Detachment Mystery
I need your input to determine when this surgeon is getting / causing a Descemet detachment during cataract surgery. This … More
1346: large Descemet detachment
Cataract surgery is a very technically challenging surgery that takes years to learn and a lifetime to master. And every … More
1338: small incision lenticule extraction
Corneal refractive surgery for myopia is done by removing some of the corneal stroma in order to flatten the central … 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
1308: corneal tattoo for cosmetic benefit
Corneal tattooing is sometimes used to help block light that enters a peripheral iridotomy and causes dysphotopsias. That is usually … More
1302: suturing a phaco wound burn
We have covered the topic of phaco wound burn many times and we even had a very astute resident prevent … More
1269: chandelier lighting for a tough case
This is an extremely challenging cataract case because the view is so limited due to the corneal status. There is … More
1253: preventing a phaco wound burn
An anonymous resident emailed me with a thank you because a pearl that was learned here on CataractCoach prevented a … More
1228: Quiz: what are these white opacities?
This is a quiz, so look closely at the above picture. This patient sustained a corneal laceration during a gardening … More
1176: cataract surgery in Fuchs’ dystrophy
You will certainly encounter patients with Fuchs’ dystrophy where the corneal endothelial cell layer becomes compromised. With loss of endothelial … More
1168: rescue this descemet’s detachment
Descemet’s membrane is very delicate and it can become detached during surgery. The usual entry site is from one of … More
1163: phaco behind the corneal scar
When a corneal scar limits the visualization, how can you still complete the cataract surgery in a safe manner? And … More
1075: Can I use EDOF with eye disease?
I am frequently asked if the new class of EDOF (extended depth of focus) IOLs can be used in eyes … More
1071: Challenging Phaco + DMEK
Prof. Dr. Martin Dirisamer from Munich, Germany is a recognized expert in DMEK surgery and he presents a challenging case … More
1023: Foreign body capsule rupture
This patient sustained a serious ocular injury: a foreign body pierced the cornea, punctured the anterior lens capsule, and now … More
Anterior Chamber Phakic IOL removal
Phakic IOLs are useful to address extreme degrees of myopia, but there are potential complications. Previously, we have featured cases … More
Descemet’s Membrane Detachment
When we make a corneal incision for cataract surgery, we must be careful to avoid damaging the attachment of Descemet’s … More
Cataract, cornea transplant, glaucoma tube
Our guest surgeon is Guillermo Amescua MD who is a faculty member at the Bascom Palmer Eye Institute in Miami. … More
anterior segment total reconstruction
This is a very complex case of a patient who had cataract surgery elsewhere and sustained complications during the procedure. … More
Combined Phaco + DMEK Surgery
Descemet Membrane Endothelial Keratoplasty (DMEK) has become the preferred surgical technique for the treatment of Fuchs’ corneal dystrophy. In the … More
Cataract Quiz: What should you do?
What are these dark spots seen in the red reflex as you are about to start cataract surgery? What do … More
warning: phaco wound burn!
This is among the most important cataract surgery videos that you will see in your lifetime. Really. I have taught … More
Cataract surgery & decentered LASIK flap
We frequently have patients with a history of prior LASIK who are now undergoing cataract surgery. We have explained in … More
Cataract Quiz: Why is the cornea cloudy?
This is a routine cataract surgery case. It is very efficient and a minimal amount of ultrasound energy is used … More
Review: Sealing Phaco Incisions
A properly constructed phaco incision will allow good access to the anterior chamber for cataract surgery and then will seal … More
Ruptured Globe: Key Teaching Points
Every ophthalmologist must know how to manage a ruptured globe. In this case it is a corneal laceration with a … More
Review: Cataract surgery after prior RK
This patient was very myopic and desired surgical correction many years before the advent of the excimer laser. As such, … More
Cataract Surgery in MegaloCornea
This patient has a huge cornea with a diameter of about 14 mm and an equally large anterior segment including … More
Should you use a trifocal IOL in Fuchs’?
This is an unusual case: the patient has Fuchs’ Corneal Dystrophy and yet we are implanting a trifocal IOL. Usually, … More