The future is here and John Ladas, MD, PhD gives us a brief lecture about the Rules of the Game … More
Category: IOL calculations
Toric IOL planning in a small eye (+29.5 D)
Our main phaco incision will induce astigmatism and multiple variables affect the degree of this change. Larger incisions have more … More
The patient has a surprise for you…
You have scheduled a patient for cataract surgery and the case seems relatively routine. The biometry was good and the … More
Review: IOL calcs in high hyperopia
Here is your challenge. You’re operating on a patient who is highly hyperopic (wearing +6.50 OD and +7.00 OS for … More
Why implant a zero power IOL?
This patient is ultra-myopic with an axial length of more than 31 mm. Using the free calculator at IOLcalc.com we … More
What can we learn from the first eye cataract surgery?
The patient had cataract surgery of the right eye two years ago. Initially, she had a plano outcome and great … More
Choosing Toric IOL Steps
For toric IOLs, we need to select the best spherical power as well as the ideal toric step. What is … More
Post-LASIK IOL Power Estimation
In eyes with prior LASIK, many different methods of IOL power estimation have been described to get more accurate results … More
Cataract Surgery in Keratoconus
When a patient has keratoconus, what is different about the cataract surgery? Can you still make your phaco incision in … More
The Most Extreme Myopia that I’ve seen in 20+ years
An average eye has an axial length of about 23 to 24 mm, but this patient had an axial length … More
Switching from a Toric IOL to a spherical sulcus IOL
We recently featured a four-part series of a single, complicated cataract case in which the phaco probe punctured the posterior … More
IOL Calcs: PLUS Precision Ladas Universal Superalgorithm
The future of IOL calculations is with methods that can evolve. A static formula is a time-limited method which will … More
For ultra high myopes, do not aim for plano!
For patients with a large degree of myopia, undergoing cataract surgery can be life changing because in addition to fixing … More
Methods for IOL calculations after prior LASIK
The three main factors in IOL calculations are corneal power, axial length, and effective lens position. Prior LASIK makes this … More
Quiz: Why did we miss the post-op target of plano?
There are many methods of IOL calculations and with every generation, these get more refined and more accurate. Most surgeons … More
What IOL Power do you choose for this patient?
This 60 year old patient is seeing you in consultation for cataract surgery. He has a significant posterior subcapsular cataract … More
Why Lens Geometry is important for IOL Calcs
The geometry of the IOL is important for IOL calculations and it must be taken into consideration. Yet, we learn … More
Learning from the IOL Calcs of the First Eye
Even with the best methods of IOL calculations (new generation formulae, artificial intelligence methods, and more), there will still be … More
IOL Calc Quiz: hitting plano in a high hyperope
Here is your challenge. You’re operating on a patient who is highly hyperopic (wearing +6.50 OD and +7.00 OS for … More
Pearls for Using Multi-focal IOLs (bifocal, trifocal)
For now, among the more reliable ways to address presbyopia is implanting a multi-focal IOL. These are typically diffractive in … More
Why implant an IOL if the power is Zero?
Sometimes, in a very myopic eye, the desired IOL power will calculate to zero diopters. An IOL of zero diopters … More
IOL Calc Quiz: Why are the eyes so different?
This patient has similar cataracts in both eyes and is preparing for cataract surgery with you. The biometry has been … More
IOL Calc Quiz: Why such different results?
A fan of CataractCoach has asked for input regarding the IOL calculations for his patient with steep keratometry. When he … More
Quiz: Should you implant a Toric IOL in this eye?
The patient is 70 years old and the corneal scar of the left eye is about 80% depth within the … More
IOL Calculation Quiz: Ultra-High Myopia
Happy New Year! We are introducing a new feature to CataractCoach.com for 2019: critical evaluation of biometry, IOL calculations, and … More
IOL Calculations in Ultra High Myopia
Most people consider high myopia to be about -10 diopters or greater. We have covered this topic extensively in the … More
IOL Power Estimation after Radial Keratotomy
My technician brought the patient to our biometer (Haag-Streit Lenstar) and it simply would not read the corneal power for … More
Cataract Surgery Challenges with Prior Radial Keratotomy
This patient had prior RK (Radial Keratotomy) done a few decades ago for the treatment of myopia. The patient was … More
Some Simple Ophthalmology Mathematics
Ophthalmology has a large degree of math, particularly when it comes to refractive surgery. Our most commonly performed and most … More
Temporal vs Superior Phaco Incisions
[Click link below for full video] Some surgeons prefer to make a superior phaco incision while others prefer a temporal … More
Should you do a Primary Piggyback IOL?
In highly hyperopic eyes and nanophthalmic eyes the required IOL power can be very high, sometimes in excess of +40 … More
Cataract Surgery in Small, Hyperopic Eyes
Small eyes make cataract surgery more difficult in many ways: there is less working room in the eye, the IOL … More
Cataract Surgery with a very shallow Anterior Chamber
This small eye suffered from angle closure and subsequent development of a white cataract. The angle closure was successfully treated … More
Cataract Surgery Technique in Highly Myopic Eyes
We have previously featured an article about doing cataract surgery in these highly myopic eyes, so we will focus on the surgical … More
Choosing Refractive Targets to maximize Depth of Field
From this photo it is obvious that the aperture size of a camera makes a large difference in the depth … More
Step-by-Step Technique for Toric IOLs
Toric IOLs can provide the added benefit of addressing astigmatism at the time of cataract surgery. They are available in … More
The Rule of Nines for Sulcus IOL Power
From CataractCoach.com: With newly developed methods of IOL power calculation, we are approaching 90% or higher accuracy of achieving +/- … More
Plano may not be best refractive outcome for every patient
Some patients may benefit from a small degree of residual hyperopia, myopia or astigmatism. There is a pride that we … More
Artificial Intelligence in IOL Calculations
Evolving IOL Calculations with Artificial Intelligence. (Watch Video Below) An experienced cataract surgeon has developed an intuition after having done … More
Cataract Surgery after Radial Keratotomy
This patient was very myopic and desired surgical correction many years before the advent of the excimer laser. As such, … More
Cataract Surgery and Pterygium Avoidance
(scroll down to see the full narrated surgical video) In most patients who have both a pterygium and a cataract, … More
Cataract Surgery with Prior LASIK
With age, everyone who lives long enough will develop a cataract. This means that today’s LASIK patients will someday need … More