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

Descemet Membrane Detachment

When we make a phaco incision that involves the cornea, there is always a risk of having focal detachment of … More

Techniques to Open DMEK Grafts

Today was supposed to be the World Cornea Congress in Boston (May 14, 2020) and even though it is cancelled, … More

DMEK surgery with pre-loaded graft

We have previously featured Descemet Membrane Endothelial Keratoplasty here on CataractCoach with a video from one of my residents and … More

Cataract Surgery with Pterygium Present

For a patient with both a pterygium and a visually significant cataract, the best option is usually to do the … More

The patient has a surprise for you…

You have scheduled a patient for cataract surgery and the case seems relatively routine. The biometry was good and the … More

Peeling off a Pupillary Membrane

In this complex case, there is a nearly complete pupillary membrane in an eye with a cataract and a prior … More

Can we use a Toric IOL in Keratoconus?

Toric IOLs have the ability to neutralize corneal astigmatism at the time of cataract surgery to improve vision for our … More

Do not vacuum near the corneal endothelium

During cataract surgery, you notice a small lens fragment or an air bubble float up to the corneal endothelium, where … More

Quiz: Cataract & Penetrating Corneal Injury

This patient had a penetrating corneal injury many years ago. When we look at the eye we can see evidence … More

Cataract Surgery after Corneal Transplant

Cataract surgery in an eye with a prior corneal transplant is more difficult and there are challenges which can alter … More

Cataract Surgery & Lattice Corneal Dystrophy

Today we have a guest surgeon, Dr Carlos Yuji Nunomura from Brazil, who is demonstrating cataract surgery in an eye … More

Working near the corneal endothelium

We have to be very careful to protect the corneal endothelial cells, particularly in the center of the patient’s visual … More

Quiz: Why is the vision 20/200?

This patient has a pre-op visual acuity of just 20/200 but the cataract does not look that bad. Also, we … More

Cataract Surgery in Keratoconus

When a patient has keratoconus, what is different about the cataract surgery? Can you still make your phaco incision in … More

Secrets to Avoid Corneal Edema after Cataract Surgery

Corneal edema can occur after cataract surgery due to a number of factors such as a higher degree of ultrasonic … More

Combined Phaco + DMEK Surgery for Fuchs’ Dystrophy

This patient has a cataract as well as Fuch’s corneal dystrophy. Her pre-operative corneal pachymetry is almost 700 microns centrally … More

Phaco Chop without using the phaco probe

This is a cataract surgery performed by a resident in training and the patient is known to have Fuchs’ corneal … More

Solving a tough case of Hexagonal Keratotomy

Featuring guest surgeon: Arun Gulani MD from Jacksonville, Florida, USA This complex case involved a patient who underwent hexagonal keratotomy … More

Descemet Membrane Endothelial Keratoplasty

The skills learned from cataract surgery, such as working within the anterior chamber and pivoting within the incisions, can be … More

Quiz: Cataract Surgery in Fuchs’ Corneal Dystrophy

Look carefully at the picture and tell me what you would do differently for this cataract surgery. This patient has … More

Small Pupil, Dense Cataract, Corneal Scar, Glaucoma

The key to approaching a difficult surgery is to use a stepwise approach. In the case presented here, we have … More

Never make your phaco incision like this!

In this anonymous video we have a phaco incision that is very poorly made. The placement is too far from … More

Descemet Detachment at the Phaco Incision

When we construct our corneal phaco incisions, we must be careful to give them the proper architecture and form. We … More

Hydration & Sealing of Corneal Phaco Incisions

A properly constructed phaco incision will allow good access to the anterior chamber for cataract surgery and then will seal … More

Cataract Surgery after 20-cut Radial Keratotomy

We have covered the topic of cataract surgery in eyes with prior radial keratotomy (RK) but this case is unusual … More

Salzmann Nodules and Cataract Surgery

Salzmann nodules occur at the limbus or peripheral cornea and can disrupt the ocular surface, even causing an irregular ocular … More

Air Bubbles to Monitor Viscoelastic Retention

Does viscoelastic stay inside the eye when we inject it there to protect the corneal endothelium? Or does it get … More

Cataract Surgery in Fuchs’ Corneal Dystrophy

Fuchs’ endothelial dystrophy is a disorder in which the corneal endothelium becomes progressively weak, leading to corneal decompensation and decreased … More

Cataract Surgery in Keratoconus

Patients with keratoconus, like all patients, eventually develop cataracts. However, cataract surgery in these keratocomic eyes is not the same … More