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Cataract Coach

Cataract Coach

Professor Uday Devgan MD, renowned Los Angeles cataract surgeon, teaches the Best Techniques for Cataract Surgery. All Content © 2018-2021 Uday Devgan

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Category: instruments

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

fibrotic capsule

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

phaco chop, pre-chop

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

cataract surgery, dirty optics

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

cataract surgery

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

cataract surgery

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

capsulorhexis

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

cataract surgery

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

cataract surgery, covid

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

#cataract, #cataract surgery

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

#cataract, #cataract surgery

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

#cataract, #cataract surgery

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

#cataract, #cataract surgery

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

#cataract surgery, iol cartridge

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

#cataract

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

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