There are a few catch phrases or sayings that I use on CataractCoach to make it easy to remember critical … More
Category: hydro-dissection & hydro-delineation
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
How to fix Iris Prolapse in Cataract Surgery
In this resident performed surgery, we encounter iris prolapse after too much hydro-dissection. This results in the iris prolapsing out … More
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
Ruptured Capsule Rescue & Anterior Vitrectomy
Very important learning case of a posterior capsule ruptured then a rescue including anterior vitrectomy.
Hydro-delineate if the Capsulorhexis appears small
In this picture, the capsulorhexis appears to be on the small side, but it is actually just about perfect with … More
Hydro-Dissection versus Hydro-Delineation
Once the capsulorhexis has been created, it is helpful to use balanced salt solution to loosen and separate the cataract … More