1855: MSICS with small pupils & weak corneas

All this week we are featuring cases of MSICS: manual small incision cataract surgery. The incision is not all that … More

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

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

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