This is a really difficult surgery because it is a posterior polar cataract and there is a pre-existing posterior capsule … More
Category: guest surgeons
1837: phaco & irido-zonulo-hyaloidectomy
This nanophthalmic eye has an axial length of less than 20 mm and is suffering from malignant glaucoma and aqueous … More
1836: phaco and irido-dialysis repair
This patient sustained ocular trauma years ago which resulted in the disinsertion of the iris root at the temporal aspect … More
1835: efficient phaco chop dense nucleus
This patient has a dense cataract — the kind where the posterior plate of the nucleus is tough and fibrous … More
1834: phaco-section and then extraction
We have previously featured this technique (and this guest surgeon) which shows the phaco-section technique. In this case, using a … More
1825: the problem with one haptic in the sulcus
This patient has femtosecond laser assisted cataract surgery with placement of a trifocal IOL two years ago. And while the … More
1824: two jerky pulls to save the capsulorhexis
We have previously covered the Little Technique to pull backwards to help save a run-out capsulorhexis. This Two Jerky Pulls … More
1822: lens snare/loop splits the bag!
The idea of a lens snare or loop to mechanically split the nucleus is decades old and we previously discussed … More
1810: severe zonular loss with Cionni ring
Cases like this are stressful and just looking at this picture should make your heart beat faster. There is a … More
1809: father vs son challenge – the son
Yesterday we featured a video (1808) from a highly experienced cataract surgeon (the father) who did a horizontal chop technique … More
1808: father vs son challenge – the father
Ophthalmology, particularly cataract surgery, is such an amazing field that it is relatively common to see generations of eye surgeons … More
1807: annular cataract with scarred capsule
It is very unusual to see this type of annular cataract where the remaining lens material is in the shape … More
1803: broken IOL complications
IOLs are delicate and when we roll them and compress them in order to fit through smaller incisions, rarely the … More
1802: when floppy iris syndrome gets ugly
As surgeons we must remember (and teach our patients) that the results of surgery are a combination of our surgical … More
1801: continual injection of viscoelastic
We use viscoelastic (also called OVD = ophthalmic visco-surgical device) during cataract surgery to protect the delicate intra-ocular structures, in … More
1800: dealing with opacified IOLs
There are times when certain hydrophilic acrylic IOLs end up become opaque with time. This is thought to be a … More
1797: experienced surgeon asks for help
This surgeon needs the collective help of our 50,000 subscribers. S/he has sent in this video with a request that … More
1789: nice chopping from a VR surgeon
I have always admired vitreo-retinal (VR) surgeons because of their ability to repair complex posterior segment problems. Many of them … More
1788: cortical cleaving hydro-dissection
I learned about cortical cleaving hydro-dissection from I. Howard Fine MD, an amazing surgeon and innovator in the world of … More
1787: tilted nucleus with severe zonular loss
This lens is so loose that it is shaking around inside the eye – a severe case of phacodonesis. This … More
1786: rescuing Argentinian flag sign
What do you do when the anterior capsule tear suddenly extends out to the lens equator? This is the dreaded … More
1785: centrally attached zonular fibers
This is an usual case where there are zonular fibers which are centrally attached onto the anterior lens capsule, so … More
1776: refractive lens exchange for hyperopia
For patients over age 60 with significant degrees of hyperopia, a refractive lens exchange (RLE) tends to be the preferred … More
1775: the IOL is sitting on the macula
This patient suffered late dislocation of the IOL+capsular bag complex and it fell into the vitreous cavity and it now … More
1774: When did the posterior capsule rupture?
I have watched this video a few times and I am still not sure when the capsule ruptured. Look at … More
1773: capsule ruptured by intra-vitreal injection
With millions of intra-vitreal injections being performed every year, an iatrogenic rupture of the posterior capsule by the needle is … More
1772: phaco + GATT to treat glaucoma
GATT is gonioscopy-assisted transluminal trabeculotomy and it was described almost 10 years ago where the trabecular meshwork can be torn … More
1769: cataract in a post-trabeculectomy eye
When performing cataract surgery in an eye with a prior trabeculectomy there are some important differences. There is going to … More
1768: brunescent dense rock cataract
This is a tough case and when you see the microscope lights turned up but still no red reflex, you … More
1767: an amazing rescue of a tough case
Our guest surgeon, Dr Steve Safran has become an expert in complex re-operations and anterior segment reconstruction, with countless cases … More
1766: when did the posterior capsule break?
Our guest surgeon, Dr Lukan Mishev, is a highly talented ophthalmologist who is an expert is anterior and posterior segment … More
1755: intumescent cataract double rhexis
Our guest surgeon does a beautiful job with this intumescent white cataract. Because the cortex has liquefied, the capsular bag … More
1754: dual site phaco trabeculectomy
This patient has both glaucoma and cataracts and the clinical decision has been made to perform both cataract surgery and … More
1753: single site phaco trabeculectomy
Our guest surgeon is using a single site to perform the cataract surgery and the trabeculectomy because this patient already … More
1750: paired incisions for astigmatism
Doing refractive cataract surgery is becoming the norm with patients desiring correction of refractive errors at the same time as … More
1748: tiny hyperopic eye & small pupil
Just watching this case is stressful. It is a very small eye with a 20 mm axial length, shallow anterior … More
1745: Ahmed capsular segment placement
This is a tough case where the surgeons learns intra-operatively that there is a quadrant of poor zonular support. An … More
1744: keratoglobus cataract surgery
Keratoglobus is a rare condition, so rare that I have never seen a patient with this condition in my career, … More
1743: measure precisely for Yamane IOLs
Precisely measuring your scleral entry points is critical to center the IOL optic when you are performing Yamane intra-scleral haptic … More
1740: dead capsular bag syndrome
In rare cases, years after a cataract surgery, we can have complete loss of zonular support with dislocation of the … More
1739: peeling a posterior polar plaque
We all know that posterior polar cataracts are challenging because at the site of the polar opacity the capsule can … More
1738: sudden choroidal hemorrhage
This is another great example of how even an experienced, expert surgeon can encounter a complication during cataract surgery. This … More
1734: the 7L rule saves the day
The 7L rule has been passed down from one generation of ophthalmologists to the next for many decades. It is … More
1733: Can you do MSICS without a peritomy?
Today I have more questions than answers. I enjoy performing the MSICS technique and even in our Beverly Hills surgical … More
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
1730: belt loop to fixate Ahmed segment
This patient sustained ocular trauma which resulted in loss of zonular support for about 180 degrees, allowing tilt and decentration … More
1727: iStent prior to cataract surgery
The standard teaching is to perform cataract surgery first and then once the IOL is in the capsular bag and … More
1725: coloboma with capsule rupture
Yesterday we featured a case of cataract surgery in a patient with a coloboma. And today we have another similar … More
1724: coloboma with zonular absence
Today and tomorrow we are featuring cases with congenital colobomas where there is an absence of part of the iris … More
1718: Marfan syndrome subluxed lens
Marfan syndrome patients develop a progressive zonulopathy with subluxation of the crystalline lens which leads to visual decline. While still … More