2640: the secret to get the nucleus out of the bag

In cataract surgery, managing a small pupil presents several intraoperative challenges, particularly in safely prolapsing the nucleus out of the … More

1899: phaco without hydro-dissection

There are a few catch phrases or sayings that I use on CataractCoach to make it easy to remember critical … 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

1623: Curriculum Lesson 8: hydrodissection

Hydrodissection sounds like such a simple step of cataract surgery but it is far more nuanced than beginners realize. A … More

1410: phaco without hydro-dissection

We routinely perform hydro-dissection during cataract surgery in order to help free the nucleus from the capsular bag. One of … More

1298: cortical cleaving hydro-dissection

This video shows the technique of cortical cleaving hydro-dissection which we have previously covered. This involves using the fluid wave … More

1252: how I handle soft cataracts

Soft cataracts require one important step for success: get the nucleus away from the posterior capsule. I like to accomplish … More

1125: Playlist: hydro-dissection

Hydro-dissection and hydro-delineation are critically important steps of cataract surgery since they allow us to carefully preserve the capsular bag … More

1072: epi-nucleus removal technique

In cases where we perform hydro-delineation and we have a separate epi-nuclear shell to remove, what is the best technique. … More

1065: Cortical Cleaving hydro-dissection

Cortical cleaving hydro-dissection was described 30 years ago by Howard Fine MD, a pioneer in the shift to modern day … More

1061: soft cataracts the easy way

It would seem that performing cataract surgery on an eye with a soft cataract would be easier. Since there is … More

1043: intra-vitreal injection punctures lens

The most commonly performed ocular invasive procedure performed in the USA is the intra-vitreal injection, with many millions done per … More

1021: the nucleus drops during phaco

This anonymously submitted video shows a complication from a resident cataract surgery. The capsulorhexis radializes in the sub-incisional area and … More

Cataract Quiz: how to rescue this case

This patient has an intumescent white cataract and we know that poses a risk of capsular run-out due to the … 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

Double Hydro-Delination Technique

Hydro-delineation is a useful technique which allows us to separate a central endo-nucleus from an epi-nuclear shell. In this case, … More

Hydro-delineation makes chopping easier

Performing hydro-delineation helps to separate the denser, central endo-nucleus from the softer epi-nuclear shell. This endo-nucleus is smaller in diameter, … More

Danger: Clear Crescent Red Reflex

When you are mobilizing a dense nucleus and you briefly see a bright, clear, crescent-shaped red reflex, you can be … 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

How much force for hydro-dissection?

When we perform hydro-dissection, how much force is needed? What volume of balanced salt solution is required? What are the … More

Epi-Nucleus Flip Technique

With a thick epi-nuclear shell, it is easier to remove it with the phaco probe as compared to the I/A … More

Fix this Iris Prolapse in 2 seconds

Really. This is not an exaggeration. If you understand the physics of why the iris is prolapsing through the incision, … More

Cortical Cataracts can cause “white-out”

Cortical cataracts occur when some of the lens material becomes liquefied, thereby blocking the visual axis. When we perform hydro-dissection … 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

Traumatic Cataract with Mydriasis: Part 2 Pupilloplasty

This patient suffered severe trauma as the result of an airbag injury from a car accident about one year ago. … More

Traumatic Cataract with Mydriasis: Part 1 cataract surgery

This patient suffered severe trauma as the result of an airbag injury from a car accident about one year ago. … More

Quiz: What happens with insufficient hydro-dissection?

What happens if the hydro-dissection is insufficient during cataract surgery? The cortex and epi-nuclear shell remain very adherent to the … More

Flip up the epi-nucleus for easy aspiration

In some cataract cases it is helpful to perform hydro-delineation to separate the dense endo-nucleus from the softer epi-nucleus. Once … More

Quiz: Why does the red reflex change during surgery?

This is a routine cataract surgery, but there is a limited red reflex during the surgery. This is sometimes due … More

How to Flip Up the Epi-Nucleus for easy removal

Hydro-delineation can be helpful to separate the dense endo-nucleus from the epi-nucleus of the cataract. This makes is a bit … More

Posterior Polar Cataract with Central Capsule Defect

We have highlighted multiple different posterior polar cataract cases, which warrant reviewing. These include: Soft Posterior Polar in a younger … More