Cataract Surgery in Pigment Dispersion Syndrome

Cataract surgery in patients with Pigment Dispersion Syndrome can be challenging due to the anatomic changes which have happened over … More

Pupil Ring placed in one movement, but there is a catch…

I wanted to try a new technique: placing all 4 scrolls of the Malyugin ring on the iris in one … More

Why is the pupil peaked during this cataract surgery?

The iris is a fluid tissue that moves within the eye in response to the fluidic changes of cataract surgery. … More

Moderate Floppy Iris Syndrome: Avoiding Prolapse

This patient took Flomax (tamsulosin) a few years ago for a brief period of time. He later stopped the medication … More

Phaco Flip in Post-Vitrectomy and Flomax Cases

Phaco flip has an advantage over other methods of nucleus division: the cataract is already partially out of the capsular … More

Resident IFIS / Iris Prolapse Cataract Case

Intra-Operative Floppy Iris Syndrome (IFIS) occurs primarily with the use of systemic tamsulosin (Flomax), a medication that aids in urinary … More

Small Pupil Flomax Adventures (without a ring!)

This is a really fun cataract surgery. After tens of thousands of cases, an unusual or challenging clinical situation really makes … More

Pupil Stretch using Capsulorhexis Forceps

To stretch a small pupil, you actually don’t need special instruments. Using two instruments such as choppers, hooks, or manipulators, … More

Avoiding Iris Prolapse when Sealing the Incision

When doing cataract surgery in patients with floppy iris syndrome, the iris has a tendency to prolapse via the phaco … More

Tips & Tricks for Using Pupil Expansion Devices

While I don’t use them often, pupil expansion devices such as the Malyugin ring, are useful when performing cataract surgery … More

Treating Iris Bleeding during Cataract Surgery

Typically, modern day phacoemsulification cataract surgery is relatively bloodless because we are making incisions in the cornea and then operating … More

Bimanual Irrigation / Aspiration for Cortex

For most cases a coaxial arrangement of both the phaco and irrigation / aspiration (I/A) handpieces works very well. However, … More

Floppy Iris Syndrome with Phaco Chop

We have a fun case here: the patient has a long-time history of Flomax (tamsulosin) use which limits his pupil … More

Managing Mild Iris Prolapse during Phaco

The iris can prolapse any time that a pressure gradient exists in front of, and behind the iris tissue. This … More

Expansion Ring for Small Pupil Cataract Surgery

For small pupil cases, I prefer to do stretching in order to expand the pupil and then I can proceed … More

Phaco Chop with Floppy Iris Syndrome

Many of our male patients take medications to help with urinary flow such as alpha-1 antagonists, the most common of … More

Bleeding from Pupil Expander! Now What?

Pupil expansion devices can be helpful to provide sufficient dilation in cataract surgery. This video features guest surgeon Ravi D. Goel, … More

3 tricks for Small Pupil + Flomax Cataract Surgery without Expanders or Iris Hooks

Can you do cataract surgery in an eye with a small pupil without having to use expanders or iris … More