This is a tough case and when you see the microscope lights turned up but still no red reflex, you … More
Category: dense cataract
1732: this white cataract is quite dense
We have previously explained that not all white cataracts are the same and that there is an entire spectrum of … 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
1656: a really tough case for a resident
For any cataract surgeon this is a tough case: 94 year old patient (nonagenarian), short axial length, shallow anterior chamber, … More
1645: phacolytic glaucoma & synechiae
Our guest surgeon does a great job with a very difficult cataract surgery. The patient has phacolytic glaucoma where the … More
1611: dense cataract with foot pedal video
Surgeons who want to learn phaco chop sometimes have a challenge with the foot pedal control. When should energy be … More
1580: phaco surgeon does great MSICS
Our guest surgeon is a very experienced cataract surgeon and an expert at phaco, but he has decided to perform … More
1571: dense brunescent whitish cataract
I recently did LASIK surgery for a young patient, in his early 20s, who surprised me when he said that … More
1557: small pupil and dense cataract
This is a fun video where I give the commentary while watching it for the first time. The case is … 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
1516: ultra dense black cataract
Our guest surgeon is an amazing surgeon, Dr Neto Rosatelli from Brazil. He presents a very, very dense cataract in … More
1515: expert management of DWC
DWC stands for dense white cataract and in this case, that is exactly what we have. In addition, the anterior … More
1514: “the toughest case of my life”
“The toughest case of my life” is quite a statement when it is said by a highly experienced, expert level … More
1487: dense central endo-nucleus
In this case, there was a dense central endo-nucleus that seemed somewhat resistant to chopping. When I chopped the nucleus, … More
1476: ASCRS case 7: dense cataract tricks
Another great case from the 2022 ASCRS CataractCoach instructional course, this time focusing on dense cataracts. There are some good … More
1453: Quiz: What is your next step?
This is a tough case where the nucleus is very dense and difficult to chop, but the bigger challenge is … More
1445: rubbery brunescent cataract
There is a pleasure in helping patients with a dense brunescent cataract: we enjoy the surgical challenge and the patient … More
1442: this nucleus is denser than it looks
This is a complete cataract case, shown start to finish, of a patient seen in my private clinic. At the … More
1441: converting from phaco to MSICS
Our guest surgeon is Jack Shao MD who is a faculty member at the Cole Eye Institute at the Cleveland … More
1382: hyper mature cataract MSICS
In an eye with a truly dense, hyper-mature cataract, MSICS (manual small incision cataract surgery) can be a better option … More
1301: dense cataract divide and conquer
The divide and conquer technique is a tried and true method for nucleo-fractis. It works well in a variety of … More
1281: flip and chop when it’s dense
This complete cataract case shows the entire surgery from first incision until the end. This allows for great learning for … More
1263: double hook pre-chop technique
Our guest surgeon, Dr Érico Jun Oda from Brazil, does a great job with this surgery. Using just two hooks … More
1254: intra-nuclear stone formation
This patient has suffered from a dense white cataract for many years. During that time the lens cortex became liquefied … More
1239: dense brunescent cataract
This patient has a very dense, brunscent, fibrous cataract in the left eye. Fortunately, the right eye has a moderate … More
1213: chop this dense cataract in the bag
This patient has a 4+ nuclear sclerotic cataract which we would classify as dense. Fortunately, it is not quite at … More
1155: dense cataract, small pupil, MIGS
This is a tough case in an 87 year old patient who has a small pupil, a dense cataract, and … More
1151: white cataract and uveitis synechiae
This patient has a long standing history of uveitis which has resulted in synechiae between the iris and the anterior … More
1144: white cataract intra-capsular surgery
Decades ago the standard cataract surgery was an intra-capsular cataract extraction. This involved making a large incision, injecting alpha chymotrypsin … More
1138: my 100 year old cataract patient
This patient is 100 years old and she now has decided that she would like cataract surgery. Certainly we are … More
1124: Pearls for learning MSICS
It may surprise you to know that many young ophthalmologists in the USA do not have experience performing MSICS. In … More
1123: dense brunescent cataract chop
This video showcases the entire surgery which we are running at 2x speed so that it is just 5 minutes. … More
1091: Dense Cataract and Nystagmus
Our guest surgeon is Dr Érico Jun Oda from Brazil and he demonstrates an expert level cataract surgery in a … More
1079: you must learn SICS / ECCE
More than 20 years ago when I was a resident ophthalmologist at the UCLA Jules Stein Eye Institute, we performed … More
1008: Horizontal Chop Technique
Our guest surgeon is Dr Hafidi Zouheir from Rabat, Morocco and he expertly demonstrates the horizontal chop technique for a … More
Pseudo-Exfoliation White Cataract
Our guest surgeon today is a young ophthalmologist from Spain and he is performing phaco for a patient with a … 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
Femtosecond Laser White Cataract
Our guest surgeon today is Xiongfei Liu MD from Sacramento, California. He was previously a resident with us at our … More
Cataract Quiz: Where is the hidden piece?
Time for another cataract quiz — look carefully at the photo above. Where is the nuclear fragment hiding? And how … More
Cataract Quiz: When did the break happen?
This patient has a relatively dense cataract and requires a toric IOL for 2 diopters of regular corneal astigmatism. When … More
Soft versus Dense Cataracts
Our guest surgeon, Dra. Luz Marina Melo from Colombia, shows us two very different techniques for soft versus dense cataracts. … More
adherent posterior capsule plaques
You are doing cataract surgery for a patient with a dense nucleus, an advanced cataract, with barely count fingers vision. … More
Rotary Chop Technique
The key to splitting a brunescent cataract is to access the central endo-nucleus. This is the densest part of the … More
Surprise! Loose Zonular Support!
This patient has a dense cataract and a surprise waiting for the surgeon: as the nucleus is being cracked, we … More
complete cataract case: great red reflex
We all love a great red reflex during cataract surgery because it makes is much easier to see details such … More
compilation video: dense cataracts
This compilation video features the best of many prior videos regarding dense cataract techniques. The video has many clips which … More
Challenge: Monocular Dense Cataract
Operating on a monocular patient is always stressful since we know that the stakes are higher due to the patient … More
Expert Surgeon versus The Rock
There is so much to be learned by watching other surgeons operate. Even after so many thousands of cataract surgeries … More
You must learn to do MSICS
In many countries where dense, brunescent cataracts are common, the SICS (small incision cataract surgery) or MSICS (manual small incision … More
Dense Cataract Vertical Chop
For a dense cataract, the vertical chop technique works well because the chop will propagate through the nucleus. We have … More