Many years ago the only phakic IOL available in the USA for treatment of large degrees of myopia was a … More
Category: incisions
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
Corneal Phaco Incision Hydration
The technique of corneal stromal hydration to help seal a phaco incision is useful to ensure a watertight incision and … More
Cataract surgery & decentered LASIK flap
We frequently have patients with a history of prior LASIK who are now undergoing cataract surgery. We have explained in … More
scleral tunnel phaco incisions
Many years ago, incisions for cataract surgery were made in the sclera, even for the small phaco incisions. The scleral … More
Compilation video: Corneal Phaco Incisions
We are starting a new feature here on CataractCoach: the compilation video, where we combine the best of many prior … More
Make 2 Paracentesis Incisions
In the USA, most surgeons use coaxial I/A for cortex removal and as such, they tend to make a single … More
Review: Sealing Phaco Incisions
A properly constructed phaco incision will allow good access to the anterior chamber for cataract surgery and then will seal … More
Learn as I coach this resident
Many ophthalmologists from around the world have asked if we offer a fellowship, externship, or clinical rotation so that they … More
Quiz: Why are there two main incisions?
Cataract Quiz: Why are there two phaco incisions in this eye? This is a routine cataract surgery and the case … More
Review: The Angle of Approach for Incisions
The angle of approach of the keratome will determine the tunnel length of our phaco incision. If the angle is … More
IOL cartridges – which one?
There are many different IOL injector systems from multiple different IOL manufacturers. It is the surgeon’s job to know the … More
Review: Why LRIs should be done at the end
Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract … More
Cataract Quiz: Where should you make the incision?
Our phaco incisions will induce an astigmatic change in the cornea and we can use that to help achieve a … 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