Time for another cataract quiz — look carefully at the photo above. Where is the nuclear fragment hiding? And how … More
Category: dense cataract
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
Submarine Chop for dense cataracts
For a dense cataract, performing phaco chop is challenging because the central lens nucleus is so hard that the chop … More
Review: Double Capsulorhexis for White Cataracts
Intumescent white cataracts pose a challenge because the lens cortex has degenerated so much that is has liquefied. This creates … More
Expert level dense white cataract surgery
It is a pleasure to watch a true expert perform his craft and this is especially true for cataract surgery, … More
Bilateral brunescent cataract surgery
This patient has been functionally blind for 10 years and presents to us with bilateral, dense, brunescent cataracts. We must … More
Fluidic Analysis during Phaco Chop
It can be helpful to see the machine fluidic parameters in real-time as the phaco chop procedure is performed. We … More
Complete Case: loose zonular support
Another great video in our series of Complete Cataract Cases: a dense cataract in the setting of loose zonular support. … More
Pit Technique for Dense Cataracts
With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult. … More
Review: Why is Phaco Chop not working?
This patient certainly needs cataract surgery because the dense nucleus has a large degree of central opacity and that has … More
Trap a dense nucleus in order to chop it
With a very dense and fibrous cataract, using just the vacuum from the phaco tip to hold the nucleus is … More
Phaco Chop in patients over age 90
In previous videos we have explained the differences when operating on nonagenarian patients. These patients have weaker tissues such as … More
Complete Case: Brunescent & White Cataract
This patient truly needs our help. She developed a cataract in the right eye a few years ago and was … More
Complete Case: Dense PSC & Shallow AC
This is a complete case, shown from start to finish. For many of our CataractCoach viewers, particularly the surgeons with … More
Guest Surgeon “Submarine Chop”
We all learn from each other and today’s video is a great example of that. We are learning from Dr. … More
Resident Surgeon takes on a Dense White Cataract
It is a pleasure to show you this video where one of my senior residents performs and excellent cataract surgery … More
Needle Puncture for Intumescent White Cataracts
An intumescent white cataract is where the cortex has become opaque and liquified which increases the pressure within the capsular … More
Should we chop in the bag or above the bag?
Should we chop the nucleus within the capsular bag or should we bring the nucleus partially out of the capsular … More
The Chop will not propagate through the cataract
With a dense cataract, a fibrous posterior plate can develop within the lens nucleus. This makes is challenging to split … More
Tilt and Chop – a SupraCapsular Technique
Supracapsular phaco techniques are in closer proximity to the corneal endothelium, which can be damaged by the ultrasonic energy from … More
For a Dense Cataract should we fix the astigmatism?
This patient has a dense, white cataract with a pre-op vision of just Counting Fingers at 1 meter (CF at … More
Review: Solution for the Dense Nuclear Posterior Plate
Looking at this image should intimidate beginning cataract surgeons: this is a whitish-brown totally opaque cataract and it is a … More
Guest Surgeon: Cataract with Fibrotic Anterior Capsule
In rare cataract cases, particularly those from prior trauma, we can get fibrosis of the anterior capsule. This makes the … More
Guest Surgeon: The UltraChopper for Dense Cataracts
Professor Luis Escaf from Barranquilla, Colombia presents a case here of a dense cataract with a small pupil. He uses … More
Guest Surgeon: Chopping a Dense, Leathery Cataract
When we describe a cataract nucleus as leathery, we mean that it is fibrous in nature and our chops and … More
Converting from Phaco to Manual ECCE Surgery
While it is rare, there are times when it is important to convert from a phaco approach to a manual … More
Double Capsulorhexis for Intumescent White Cataract
Intumescent white cataracts pose a challenge because the lens cortex has degenerated so much that is has liquefied. This creates … 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
White Cataract Posterior Capsule Rupture!
In this anonymous video from a surgeon in training, we have quite the challenge: a dense white cataract surgery where … More
Wrinkled Anterior Lens Capsule – be careful!
poor zonular support cataract surgery
Hydro-delineate for a dense central nucleus
When you see a patient with a dense central endo-nucleus, there are characteristic findings: a lens periphery that is relatively … More
Guest Surgeon: White Cataract Stop-and-Chop
It is good to learn from various techniques from many different surgeons. You get to see the differences and similarities … More
Fixing a Radialized Capsulorhexis in manual ECCE
When I first started teaching residents about 20 years ago, we would have the residents do about 10 surgeries of … More
Novice Surgeon attempts a Dense Brunescent Cataract
Today we feature a brave and talented young surgeon who has only about 30 cataracts of experience so far. And … More
Solution for Incomplete Phaco Chops
You’re an experienced phaco chop surgeon and you come across a case where you just cannot get the chop to … More
Routine Dense White Cataract Surgery
Finishing up our week of routine cataract cases, today we are reviewing dense white cataracts. In some parts of the … More
Surgical Approach for a Morgagnian Cataract
With a white cataract, typically the cortical layers opacify and may partially liquify, and that can make the surgery more … More
Why is phaco chop not working here?
This patient certainly needs cataract surgery because the dense nucleus has a large degree of central opacity and that has … More
3 critical differences in Cataract Surgery for patients over Age 90
Average life expectancy is at an all-time high in the US at 79, with even better news for … More
What is the critical finding here?
The first year resident correctly identified the white cataract of the right eye, but she missed a critical finding. As … More
White Cataract: Solution for the Dense Posterior Nuclear Plate
Looking at this image should intimidate beginning cataract surgeons: this is a whitish-brown totally opaque cataract and it is a … More
White Cataract: What is USA Flag Sign? (Hint: Femto)
The USA Flag Sign is seen when we use a femtosecond laser to assist in phaco of a white cataract. (scroll … More
White Cataract: Capsulorhexis x 2 in the same eye!
Double-Capsulorhexis Approach to the Intumescent White Cataract (Scroll down for the surigcal video of the Capsulorhexis x 2 Technique) The … More
White Cataracts: They are not all the same!
You’ve seen the notation in the patient chart: “DWC” which stands for Dense White Cataract, but there is actually a … More
Older Surgical Techniques Still Matter
Yes, I love phaco too, but we should all learn to do SICS as well. (Classic ECCE teaching video below) This … More
Posterior Polar Cataract: Expert Level with Small Pupil, Floppy Iris, Dense Lens
Yesterday’s video showed the technique of using Visco-Dissection to aid in surgery for posterior polar cataracts. That patient had a … More
Combo Chop: Combining the Advantages of Horizontal and Vertical Phaco Chop
Phaco chop revisited: Combo-chop combines horizontal and vertical chop techniques Combining the advantages of the two techniques can simplify the … More
Approach to the Dense Brunescent Cataract
With Increased Nuclear Density comes Increased Risks Here is how to successfully approach these tough cataract surgery cases: Patients with … More