In cataract surgery we are taking out a 4 to 5 mm thick human crystalline lens and replacing it with … More
Category: instruments
1678: can you chop with any instrument?
I have said it before, the hands are more important than the equipment. And the technique is more important than … More
1668: femtosecond laser fragmentation
We have covered the topic of femtosecond lasers in cataract surgery many times before. Most cataract surgeries performed in the … More
1639: intumescent & pressurized cataract
Increasing lens thickness indicates danger in cataract surgery because liquefied lens cortex can pressurize the capsular bag, increasing the risk … More
1572: create your own nucleus slicer DIY
DIY means Do It Yourself and it is something that appeals to so many people, including me. In this video … More
1523: Zepto for intumescent cataracts
We have seen the videos before where the Argentinian Flag sign develops instantly as the anterior lens capsule splits uncontrollably. … More
1418: advantages of Zepto capsulotomy
There are many ways of performing the steps of cataract surgery. We can do the capsulorhexis / capsulotomy with a … More
1387: Zepto Precision Pulse Capsulotomy
The Zepto device uses a brief pulse of electricity to instantly create a precision capsulotomy in the anterior lens capsule. … More
1333: pre-chopper for nucleus division
The pre-chopper is an instrument with two blades which are shaped like paddles and they are embedded into the nucleus … More
1295: how to un-inject an IOL to explant
IOL exchange is an unusual procedure and it is safe to say that more than 99% of patients who receive … More
1256: you don’t need a pupil ring
If you are still a beginning surgeon or a resident surgeon, there may be a tendency to use pupil expansion … More
1247: Bent Needle Pre-Chopper
Our guest surgeon, Val Apostolov MD, has been featured on CataractCoach many times before. He is an innovative surgeon who … More
1246: BANG glaucoma technique
When I first met Arsham Sheybani MD at a meeting a few years ago, I could tell that I was … 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
1153: is femto laser phaco better?
Despite more than a decade of use and hundreds of published papers, there is still some controversy as to the potential … More
1140: IOL punch for suture fixation
There are many different techniques for suture fixation of an IOL to the sclera: Yamane, Canabrava, Gore-Tex, belt loop, and … More
1009: Cutting a Fibrotic Lens Capsule
In some white cataracts, the lens capsule can become fibrotic as the lens cortex becomes absorbed and the capsule contracts. … More
Simplified Pre-Chop Technique
The pre-chop technique refers to mechanically breaking the nucleus into smaller pieces prior to inserting the phaco probe into the … More
clean your optics & focus the microscope
This is actually a very important lesson. Your microscope optics will determine your view for the surgery and that could … More
Phaco tip bevel down for chop
Many viewers of CataractCoach.com ask me why I prefer to have the phaco tip bevel down for cataract surgery. The … More
cannula for cortex aspiration
Bimanual irrigation/aspiration for cortex removal has an advantage: it is easy to switch hands and then access a full 360 … More
measure the capsulorhexis in high myopia
Eyes come in a spectrum of sizes, particularly with the measurements of the anterior segment in patients with extreme refractive … More
Safety with Cannula Use – be careful!
Beginning surgeons do not always realize that the force created by using small 27g cannulas can be quite high. If … More
Does cataract surgery pose a viral risk?
Our colleagues from the University of Toronto recently did an experiment to determine if cataract surgery poses a risk of … More
Review: Chopper protects the capsular bag
We work in a very tiny space of just a fraction of a milliliter: the volume of the anterior chamber … More
Fixate the eye with your other hand
The problem with using two hands to hold the capsulorhexis forceps is that you lose the ability to have the … More
Examine instruments before using them
We must examine our instruments before using them to ensure that they are intact and in normal, working condition. In … More
Capsulorhexis forceps with ruler marks
Our guest surgeon is Dr. Ron J. Smith who has been instrumental in teaching cataract surgery at UCLA for the … More
Lens Snare Technique
More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to … 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
Step-by-step: Malyugin Pupil Ring
To perform cataract surgery in an eye with a small pupil, it helps to expand the pupil to a more … More
The Chopper Push Technique
Watch this video carefully and you will see that the chopper instrument is used just once to create a single … More
What are these lines? What is Reflux?
These lines are the posterior capsule which has found its way into the suction port of the I/A probe. We … More
Setting Up for Cataract Surgery
Cataract surgery is team work and the surgeon is just one member of the team. We need a great team … More
Checking the IOP at the end of surgery
We want to ensure an appropriate intra-ocular pressure (IOP) at the end of surgery. This puts the eye in a … More
Three-piece IOL: B versus C cartridge
There are two options for injecting an Alcon three-piece IOL using the Monarch injector: the B cartridge is bigger and … More
How far do you insert the Chopper for Phaco Chop?
A young surgeon who is new to phaco chop asked me how deep to insert the chopper tip into the … More
Cataract Quiz: What complication will happen next?
Cataract Quiz: look carefully at the IOL in the injector cartridge. Now it’s time to implant the IOL into the … More
Review: Surgical Peripheral Iridotomy
There are times when you will need to make a surgical iridotomy either during cataract surgery or as a stand-alone … More
Cataract Quiz: What is this white plume?
The phaco probe is placed in the eye at the beginning of the cataract surgery and when ultrasonic energy was … More
Watch out for the tubing lines!
This is a simple, but important, lesson: keep the tubing lines and the phaco power cord away from your surgical … More
Review: How to Handle IOL Haptic Twist
When we inject a three-piece acrylic IOL into the eye, we must be very careful to ensure that the IOL … More
CTR Technique with less capsular stress
We have featured prior videos about insertion of capsular tension rings (CTRs) during cataract surgery. These devices can be very … More
Capsulorhexis technique with just forceps
In more than 99% of my cataract surgery cases, I do not use a cystotome to start the capsulorhexis. I … More
What is the correct way to hold a fluid syringe?
When we have a syringe that is filled with liquid, be it balanced salt solution or visco-elastic, we have a … More
Resident surgeons must learn to load the IOL
The surgeon must know how to do every single part of the surgery, including setting up the phaco machine and … More
Synechiae & Small Pupil solved with the B-Hex ring
This video features guest surgeon Neto Rosatelli MD from Brazil showing us his approach to cataract surgery in a uveitic … More
Tracing a Circle to make the Capsulorhexis
A very simple technique for new surgeons who are struggling with the capsulorhexis is to trace the intended path with … More
Optimizing the Red Reflex during Surgery
Illumination through the ophthalmic microscope is important for visualization during cataract surgery. We use a combination of both coaxial and … More
Review: Adjusting the phaco tip & I/A tip
For coaxial instruments like the phaco probe and the irrigation/aspiration probe, what is the best position for the silicone sleeve … More