2923: careful with dimple down incisions

Creating a clear corneal incision requires a precise approach to ensure the wound is self sealing and stable throughout the … More

2798: this incision is really not good

In our video today a resident surgeon performs case number 88 which is actually pretty good but the incision is … More

2794: how to make a scleral tunnel incision

Clear corneal incisions have become the default entry point for routine phacoemulsification due to their simplicity, rapid healing and low … More

2521: trying to deliver the IOL but…

Yesterday’s video featured a case where the incision was too small and the IOL became stuck. Today’s video is me … More

2362: Wong Pocket Incision

The Wong pocket incision technique is a clever way to help seal your main corneal phaco incision. This involves creating … More

2206: why not use the laser for incisions?

This patient is having cataract surgery with the assistance of the femtosecond laser. The surgeon has elected to use the … More

2205: Diamond Keratomes are Best

I have been a strong proponent of using diamond keratomes for more than 20 years. They are honed from gem … More

2079: Review: Phaco Wound Burns

This is a review video of a topic which we have previously covered. It is critically important, especially for younger … More

2002: corneal phaco incisions with RK

Decades ago millions of people had radial keratotomy (RK) as a corneal refractive surgery to address myopia. This tended to … More

1999: using the 11 blade for phaco incision

The cost of cataract surgery is high and with so many disposable items per case, the environmental cost is also … More

1930: three very interesting short cases

Today we are featuring three very interesting short cases. The first is performing simultaneous incisions like some famous Brazilian surgeons, … More

1856: MSICS with temporal approach

While the most common location for the MSICS incision is superior, we can also make this incision at the temporal … More

1792: Verisyse phakic IOL removal

Many years ago the only phakic IOL available in the USA for treatment of large degrees of myopia was a … More

1763: Curriculum Lesson 18: finish the case

This lesson focuses on finishing the case. Sounds easy, but it can be tricky. We need to remove the viscoelastic … 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

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

1722: scleral tunnel for radial keratotomy

I have done cataract surgery for well over 1000 patients with prior radial keratotomy and on a recent surgical line-up, … More

1649: phaco wound burns

This video is critically important, especially for younger surgeons, because a phaco wound burn is a complication that happens more … More

1641: the keratome just cannot penetrate

This is a case from a resident surgeon who is learning cataract surgery. And the big initial challenge is making … More

1599: leaky paracentesis causes issues

You may think that a paracentesis incision is trivial and has little effect on the case, but that is not … More

1592: off-axis incisions and toric IOLs

Your surgically induced astigmatism (SIA) from your standard phaco incision is probably far less predictable than you think. There are … More

1589: optimzing the incision in RK eyes

The cornea in patients with prior radial keratotomy is very delicate and prone to a higher rate of complications during … More

1581: curriculum lesson 5: phaco incisions

The incision is a critically important part of your surgery. As one of the initial steps, it can determine the … More

1564: on-axis incisions for toric IOLs

In most cases, I like to make the phaco incision on the steep meridian of corneal astigmatism. If the patient … More

1507: the main incision rips – now what?

What would you do if the main phaco incision ripped during your procedure? This will certainly cause a fluidic imbalance … More

1498: Wong hydration pocket incision

The Wong hydration pocket incision is an innovative way to help seal a corneal phaco incision. It involves creating a … More

1497: analyzing the incision with OCT

Look carefully at your phaco incision to see if you are making the mistake of the chevron incision. The roof … More

1466: MSICS: temporal incisions

Incisions for phaco surgery are usually made either temporal or superior. For MSICS, we typically make the incision superior because … More

1343: operate on the steep axis if possible

Some beginning surgeons like to shift the phaco incision in order to maximize their “hand comfort” even if that means … More

1332: another femto laser cataract surgery

Why did the surgeon in this video use a steel blade to make the main incision? The femtosecond laser can … More

1330: resolving intra-op chemosis

Conjunctival chemosis can happen during cataract surgery if one of our incisions nicks the edge of the conjunctiva. This allows … More

1313: review of the single plane incision

This video includes slow motion video at half-speed and then at quarter-speed to review the single plane incision. The goal … More

1302: suturing a phaco wound burn

We have covered the topic of phaco wound burn many times and we even had a very astute resident prevent … More

1261: Why is the AC so shallow in IA?

Remember that we are operating in a very tiny space of less than 1 milliliter of volume and that we … More

1253: preventing a phaco wound burn

An anonymous resident emailed me with a thank you because a pearl that was learned here on CataractCoach prevented a … More

1237: leave your signature on every case

Taking pride in your work is critical for success. You need to put the effort to do a beautiful job … More

1225: a bad incision leads to iris damage

The incision is a very important part of the cataract surgery. It determines the access to the anterior segment and … More

1217: finally a great phaco incision

When residents are learning cataract surgery, one of the struggles is getting the phaco incision right. The incision is critical … More

1199: predicting a phaco wound burn

A phaco wound burn is a terrible complication that happens from the heat that is created by the friction of … More

1184: diamond blades / keratomes

Diamond keratomes make the best incisions for cataract surgery because they are incredibly sharp and make very clean cuts in … More

1170: sealing of paired phaco incisions

Using paired full-thickness incisions to treat corneal astigmatism is an established technique that has been used for many decades. We … More

Descemet’s Membrane Detachment

When we make a corneal incision for cataract surgery, we must be careful to avoid damaging the attachment of Descemet’s … More

Never make an incision like this!

This is a resident case where the incision has terrible construction. The primary mistake is gliding the keratome along the … More

Double Phaco Incisions to fix Astigmatism

double phaco incisions for treatment of astigmatism

Complicated Radial Keratotomy Case

This is a tough case where the patient had prior 16-cut radial keratotomy for treatment of a high degree of … More

Playlist: Phaco Incisions

The phaco incision is a critical part of the cataract surgery. A great incision is the mark of an accomplished … More

Bad Incisions lead to trouble

This anonymous resident starts the case with a poorly placed and poorly constructed incision. It ends up bleeding, allowing blood … More

warning: phaco wound burn!

This is among the most important cataract surgery videos that you will see in your lifetime. Really. I have taught … More

Incisional Techniques for Astigmatism

Cataract surgery can be our most powerful refractive surgery procedure, correcting high degrees of myopia, hyperopia, and even astigmatism (with … More