Despite more than a decade of use and hundreds of published papers, there is still some controversy as to the potential … More
Category: instruments
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
Adjust the speculum to make access easier
We often will move the positions of our incisions to provide a better result for the patient or a more … More
What’s on my Cataract Surgery Instrument tray?
In this video I take you through my instrument tray for routine cataract surgery. As you can see in this … More
Superior Incision: Hand Position & Microscope Views
While I prefer the temporal approach for routine cataract surgeries, some surgeons prefer a superior incision. Many beginning surgeons who … More
Use the chopper to protect the capsular bag during phaco
The chopper can do so much more than just divide the nucleus into pieces. The chopper can fixate the eye, … More
Hand Positioning during Cataract Surgery
When performing micro-surgery, particularly intra-ocular surgery like cataract surgery, a high level of precision is required. The surgeon’s hand positioning … More
Pearls for Using Iris Hooks to Expand Small Pupils
Sometimes, the best approach to expanding a small pupil for cataract surgery is to use iris hooks. These are small, … More
Use the Chopper to Push Nuclear Pieces to the Probe
The chopper is used for many different functions during cataract surgery, beyond just chopping the nucleus into smaller fragments. Cataract … More
Exquisitely sharp blades are needed for eye surgery
The eye is like an under-inflated balloon: the low pressure inside allows it to absorb most jabs without being punctured. … More
Proper Form for using a Keratome Safely & Precisely
you must learn proper form for keratome use in cataract surgery
Use the Chopper to protect the capsular bag
We work in a very tiny space of just a fraction of a milliliter: the volume of the anterior chamber … More
use of an AC maintainer in Cataract Surgery
An anterior chamber maintainer is an additional infusion cannula which is inserted via the cornea or limbus in order to … More
Use of a Simcoe Cannula in Cataract Surgery
This video features guest surgeon Rob Melendez MD from New Mexico, USA. Dr. Melendez is a highly talented surgeon with … More
Measure the Capsulorhexis for best results
The capsulorhexis is important for successful cataract surgery because it gives the capsular opening strength during cataract removal and allows … More
Avoid Posterior Pressure from the Speculum
We need to place a lid speculum to get the best exposure for cataract surgery, but if we crank it … More
Adjusting the sleeve of the Phaco and 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
How far into the eye do you insert the keratome?
When making your phaco incision, it is important to have the appropriate tunnel length as well as incision width. We … More
How to Split the Cataract if the Chop is incomplete
Sometimes when we perform phaco chop, the lens does not fully divide. The chop scores and partially splits the nucleus, … More
Horizontal Phaco Chop for Efficient Cataract Surgery
The original phaco chop technique described by Dr. Nagahara in 1995 was the horizontal chop. This involves holding the lens … More
How to inject a 3-piece IOL when the haptics twist
When we inject a three-piece acrylic IOL into the eye, we must be very careful to ensure that the IOL … More
Tips & Tricks for High-Power IOL Delivery
A high-power IOL is not the same as an IOL with an average power, primarily because the increased power of … More
Please do NOT use the iris to guide Capulorhexis size!
Many surgeons use the iris or pupil size as a guide for capsulorhexis creation — but you should not. Do … More
Use the Chopper for Hemi-Nucleus Management
The chopper can do so much more than chop. It can be used to fixate the eye via the paracentesis, … More