expert white cataract capsulorhexis

CataractCoach has advised the beginning surgeons to improve the dexterity of the non-dominant hand and this case is a great … More

Cataract Quiz: What happened here?

Our quiz features a video from Gustavo Hüning, MD, MBA from Brazil and it shows an unusual situation that happens … 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

Phaco Chop without Vacuum

It is a pleasure to watch an expert surgeon doing cataract surgery and I really enjoyed learning from Dr. Alex … More

recovering from Argentinian Flag Sign

We have explained in great detail the techniques that can help to prevent the dreaded Argentinian flag sign with intumescent … More

Cataract Quiz: Trapped Air Bubble

We have a great learning case from Dr. Xiaogang Wang from Taiyuan, China with a surgical challenge. This patient has … More

Drill and Chop Technique

With a dense cataract, more effort and force is needed to chop the cataract. Usually with phaco chop, it is … More

recovering from posterior capsule rupture

Every surgeon, no matter how experienced, will experience complications. The rate of complications such as posterior capsule rupture declines substantially … 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

Equanimity under Duress

When Sir William Osler left the University of Pennsylvania’s Medical School (the first one in the USA, started in 1765) … More

Glaucoma Drainage Implant Technique

I have learned so much from the video submissions that we receive at CataractCoach. It makes me wonder how I … More

Intumescent Cataract Auto Aspiration

We know that intumescent white cataracts can be challenging because the lens capsule is pressurized with liquefied lens cortex. This … More

Mastering Stop-and-Chop phaco

Stop-and-chop is a common technique in phaco cataract surgery because it is safe, efficient, and relatively easy to learn. We … More

Safety with Cannula Use – be careful!

Beginning surgeons do not always realize that the force created by using small 27g cannulas can be quite high. If … More

Lateral Phaco Chop Technqiue

With traditional phaco chop, we place the chopper in front of the phaco probe tip, but there are other options. … More

Capsulorhexis Pearls

By watching many surgeons, we can learn different ways of performing the same procedure. In this case, Dr Luis Escaf … More

Peeling Capsular Membranes

We present another great learning video from Dr. Val Apostolov from Amsterdam, The Netherlands to show the techniques of peeling … More

Bare Sclera Pterygium Surgery

There are many ways to do the same surgery and the best option is for us to learn about all … More

Fibrotic Dense White Cataract

This patient developed a white cataract years ago and was unable to seek treatment for a prolonged period of time. … More

Uveitic Dense White Cataract

This dense white cataract is further complicated by being an a uveitic eye with a fibrotic membrane causing a small … 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

Draining a choroidal hemorrhage

We recently featured a video of a sudden choroidal hemorrhage which happened during implantation of an IOL. This is a … More

Mastering Divide-and-Conquer

Most young ophthalmologists start learning phacoemulsification cataract surgery with the divide-and-conquer technique. This is an easier technique to learn than … More

Pediatric Posterior Capsulorhexis

Our guest surgeon is Ike K. Ahmed MD from the Prism Eye Institute in the greater Toronto area. He is … 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

Spiral Capsulorhexis Technique

After needle decompression of the cataract, using a spiral technique for the capsulorhexis has a distinct advantage: if there is … 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

White cataract needle decompression

We know that an intumescent white cataract is fluid-filled with liquefied lens cortex. This makes the pressure within the capsular … More

Small incision glaucoma surgery

This video is amazing — when I first saw this technique, I was in awe because I learned so much. … More

Residual posterior polar opacities

We love to show posterior polar cataract videos and we have an entire category for them here on CataractCoach. Using … More

Small pupil, PXF, and IFIS

For a beginning surgeon it is helpful to see surgeons performing techniques that are out of your comfort zone. The … 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

Fixing severe capsular phimosis

In a small number of patients, capsular phimosis can happen after cataract surgery. This can lead to severe distortion of … More

Resident Cataract Surgery Final Exam

Today is June 30 and that is the final day of residency training in the USA since our academic year … 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

Anterior Capsule Rips Uncontrollably

Quiz time: What do you do when the anterior capsule rips uncontrollably in a young patient who is scheduled to … More

2 approaches to Posterior Polar Cataracts

Studies have shown that 1 out of 3 posterior polar cataract surgeries result in a ruptured posterior capsule. Here’s the … More

Pre-Chop with just 2 Choppers

Guest surgeon Dr Valentin Apostolov from Amsterdam shows us his technique for splitting a dense nucleus into small fragments before … More

Recovering from Argentinian Flag Sign

We have an entire section devoted to achieving success with white cataracts, including intumescent white cataracts. But even in expert … 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

Does cataract surgery pose a viral risk?

Our colleagues from the University of Toronto recently did an experiment to determine if cataract surgery poses a risk 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

Pre-Chop Variations for Cataract Surgery

In this video, submitted by Dr. Yaun Lin from Casablanca, Morocco, we can learn multiple different variations of Pre-Chop. This … More

Expulsive Choroidal Hemorrhage!

This video is a MUST SEE! An expulsive choroidal hemorrhage is a rare complication than any cataract surgeon must be … More

Capsulorhexis forceps with ruler marks

Our guest surgeon is Dr. Ron J. Smith who has been instrumental in teaching cataract surgery at UCLA for the … More

Cataract Quiz: Rescue this Rhexis!

For this Cataract Quiz we have guest surgeon Dr. Naveen Gopal from Bangalore, India showing us a tough case that … More

Congenital Iris Coloboma Repair

We have another video from master surgeon Dr. Valentin I. Apostolov from Amsterdam. In this video he shows us his … More

Trabeculotomy & Cataract Surgery

Because cataract surgery alone tends to decrease intra-ocular pressure, there is often a benefit of combining it with glaucoma surgery. … More

Pupillary Cerclage Technique

In cases of chronic traumatic mydriasis, we can use sutures to reconstruct a pupil of a reasonable diameter. We have … More

Lens Snare Technique

More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to … 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

Artificial Intelligence in Ophthalmology

The future is here and John Ladas, MD, PhD gives us a brief lecture about the Rules of the Game … More

Manual SICS with nucleus bisection

SICS is small incision cataract surgery, and it refers to a method of manual expression of the nucleus through a … More

Posterior Polar without delineation

Posterior polar cataracts are unusual, but certainly every ophthalmologist will see these patients in their own clinics. While most surgeons … More

Two-Handed Capsulorhexis Technique

Our guest surgeon is Ravi Goel MD from New Jersey, USA who is also the author of the ProtectingSight.com blog. … 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

Spiral Out Capsulorhexis for Intumescent Cataracts

Some white cataracts are intumescent which means that the capsular bag is filled with liquefied lens cortex. This fluid increases … More

Cataract Quiz: What is this white plume?

The phaco probe is placed in the eye at the beginning of the cataract surgery and when ultrasonic energy was … More

Severe Capsular Phimosis

Capsular phimosis occurs when there is severe contraction of the anterior capsular tissue which results in a shrinking of the … More

Artificial Iris Implants

Kevin M. Miller MD is a world-renowned cataract surgeon at UCLA’s Jules Stein Eye Institute and he was an instrumental … More

Tear Out of the Anterior Capsule

In this video, which was anonymously submitted, an experienced surgeon encounters a routine cataract case where the anterior capsule is … More

White Cataract with Fibrotic Lens Capsule

This video was submitted by an anonymous surgeon who is attempting this case early in the course of surgical training. … More

Guest Surgeon Phaco Chop Technique

One of the hallmarks of a good surgeon is the ability to learn from other surgeons. In this case we … 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

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

Evaluation of Tilt-and-Tumble Phaco

An anonymous surgeon has submitted a video of the tilt-and-tumble phaco technique which tends to work well with milder degrees … More

Expert Level Divide-and-Conquer

Many surgeons like the divide-and-conquer technique and it is widely used here in the USA. For young surgeons, it is … More

Guest Surgeon: Phaco Chop Technique

This video was anonymously submitted by an experienced surgeon who wants us to analyze the phaco chop technique and give … More

Pre-Chopper Phaco Technique

There are many different ways to divide the nucleus during cataract surgery. Phaco of smaller nuclear fragments is easier and … More

CTR Technique with less capsular stress

We have featured prior videos about insertion of capsular tension rings (CTRs) during cataract surgery. These devices can be very … More

Analysis of a Divide-and-Conquer Cataract Case

This anonymously submitted video is from a surgeon who is 5 years into practice after the culmination of her training. … More

Guest Surgeon Efficient Divide-and-Conquer

After thousands of cases, surgeons become very efficient and can complete cataract procedures with fewer instruments and less surgical trauma. … More

Two important danger signs in traumatic cataract

Guest surgeon and expert Ashraf Armia MD shows us two very important danger signs in a traumatic cataract case: wrinkles … More

Toric IOL with intra-operative aberrometer use

Guest Expert John Hovanesian MD implanting a Toric IOL with aberrometer guidance Dr. Hovanesian is a well-known and much respected … More

Where did the hemi-nucleus go?

This video was submitted by Dr Ravi Prasad Challa from India and it showcases a very rare complication: a break … More

Pars Plana Anterior Vitrectomy can be very helpful

When the capsule breaks during cataract surgery and the vitreous prolapses into the anterior segment, it is important to clear … More

Synechiae & Small Pupil solved with the B-Hex ring

This video features guest surgeon Neto Rosatelli MD from Brazil showing us his approach to cataract surgery in a uveitic … 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: What is this large central opacity?

Quiz time: What is this large central opacity seen in the anterior chamber? The patient is scheduled for cataract surgery … More

Review: Beginning Surgeon Learns Phaco Chop

You’ve seen countless videos of phaco chop, but you seem to be stuck in a mode of less efficient techniques … More

Dense Morgagnian Cataract with Capsule Break

With a Morgagnian cataract, the entire cortex becomes liquified and then the remaining lens nucleus floats within this fluid. In … More

Guest Surgeon: Pre-Pocket Phaco Incision Technique

Dr. André Berger from São Paulo, Brazil has developed a new technique for creating a corneal phaco incision: the Pre-Pocket … More

Analysis of a Resident’s 60th Cataract Surgery

As we get close to starting the academic year in the USA (which runs from July 1, 2019 to June … More

Analysis of a Resident’s 50th Cataract Surgery (Part 2)

Continuing from the previous post, this is part 2 of 2 of the analysis of a resident’s 50th cataract surgery. … 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: Recover from the Argentinian Flag Sign

In our many videos about white cataracts (full series can be found here), we know that one of the biggest … 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

Guest Surgeon: Soft Posterior Polar Cataract Surgery

We have featured many videos about posterior polar cataracts and the techniques that can be used to successfully operate on … More

Guest Surgeon teaches us Cataract Surgery Efficiency

We can always learn from fellow surgeons, particularly from those who are truly experts in the field. I recently met … More

Review: Complete this case without vitreous prolapse

This is a great learning case from one of our young surgeons in training. The video is 14 minutes long … More

Guest Cataract Surgery: Tiny Pupil with Synechiae

This patient had a prior uveitic episode which resulted in the formation of posterior synechiae, where the iris, at the … More

Be Careful if you see the Hole Punch Sign during Phaco

In your first 1000 cataract surgeries, the most common cause of a posterior capsule rupture is iatrogenic damage from the … More

Intentional Capsule Puncture with a Phaco Probe

For intumescent white cataracts we must take special precautions. The capsular bag is fluid-filled and pressurized and there is the … 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

Guest Surgeon: Femto & Capsular Tension Segments

This is a tricky case: a traumatic cataract with extensive zonular loss and weakenss in a younger patient with high … More

Guest Surgeon: Cataract with prior Trabeculectomy

This is a great video submitted by Dr. Mohammed Ghoneem from Alexandria, Egypt where he shows his method for successful … More

use of an AC maintainer in Cataract Surgery

An anterior chamber maintainer is an additional infusion cannula which is inserted via the cornea or limbus in order to … More

Focal lens opacity after intra-vitreal injection

This patient had multiple prior intra-vitreal injections for macular disease and now presents to you for cataract surgery. Upon examination … More

Use of a Simcoe Cannula in Cataract Surgery

This video features guest surgeon Rob Melendez MD from New Mexico, USA. Dr. Melendez is a highly talented surgeon with … More

Expert Technique: Small Pupil & Dense Cataract

Very experienced surgeons never rest — they are always looking to learn more. Like you, I learn a lot from … More

Pre-Chop the Nucleus to Help a Novice Surgeon

Today we have a video of a novice surgeon operating together with an experienced surgeon. The key maneuver in this … More

Guest Surgeon: Capsular Bag Power Wash Technique

Our guest surgeon, Dr. Anton A. Eijpe from the Netherlands, demonstrates his technique of capsular bag power washing using balanced … 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

Should you try to rescue a dropped nucleus?

For most situations, I recommend that if the cataract nucleus drops into the vitreous cavity due to a ruptured posterior … More

Wait! Is the Posterior Capsule Ruptured?

In this video which was submitted anonymously, the guest surgeon had a routine case with an intact capsulorhexis. But then … 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

When to Revert to a Can-Opener Capsulotomy

We have learned from the past two days of videos, that it is sometimes wise to revert to a can-opener … More

Complications from a Failed Capsulorhexis

There is a great deal of learning from this video where a failed capsulorhexis leads to a host of issues … More

Why you MUST learn Phaco-Chop (Resident Case)

A critical part of being an accomplished ophthalmologist is keeping up with the advances in your field. For cataract surgery, … More

Ocular Albinism Cataract Surgery

Ocular albinism poses a number of challenges for cataract surgery. The patient often has concomitant nystagmus, underlying amblyopia, macular issues, … More