On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
Category: IOL related
1803: broken IOL complications
IOLs are delicate and when we roll them and compress them in order to fit through smaller incisions, rarely the … More
1800: dealing with opacified IOLs
There are times when certain hydrophilic acrylic IOLs end up become opaque with time. This is thought to be a … More
1795: IOL exchange is not always the solution
When patients need it, I am a firm believer in IOL exchange. We can go back inside the eye and … More
1794: Eyhance OD and Vivity OS – why?
This patient is a physician from the east coast of the USA (more than 3000 km from my clinic) who … More
1749: Curriculum Lesson 17: IOL delivery
In this next part of our curriculum series, we have lesson 17: IOL delivery. It may sound simple, but injecting … More
1743: measure precisely for Yamane IOLs
Precisely measuring your scleral entry points is critical to center the IOL optic when you are performing Yamane intra-scleral haptic … More
1737: IOL breaks the posterior capsule
We should never devalue cataract surgery or claim that it is such an easy procedure because even in expert hands, … More
1735: Curriculum Lesson 16: IOL loading
Continuing with lesson 16 in our Curriculum series, focusing on IOL loading. Every surgeon must know how to load the … More
1734: the 7L rule saves the day
The 7L rule has been passed down from one generation of ophthalmologists to the next for many decades. It is … More
1677: cataract surgery & phakic IOL removal
This patient had a phakic IOL placed many years ago for the treatment of a high degree of axial myopia. … More
1676: this IOL is going in upside down
The 7L rule makes my life so much easier. This rule states that the leading haptic should look like the … More
1674: IOL choice in a teenager
This young patient presents with dense posterior subcapsular (PSC) cataracts in both eyes which is severely limiting the vision. The … More
1669: Juvene IOL – Grail Study Results
Truly accommodating IOL offers promising results Ophthalmologists have been searching for effective ways to address presbyopia for many decades, particularly … More
1666: IOL exchange for glare, halos
Some patients just cannot tolerate a trifocal IOL design and that is compounded if the refractive target is missed and … More
1661: X-NIT simplifies Yamane IOL fixation
Our guest surgeon has developed a novel technique for simplifying the Yamane IOL scleral fixation procedure. Typically with the Yamane … More
1643: limitations with the Vivity IOL
***I mis-spoke at the 1 min mark: small aperture is more depth of field and longer shutter time. The large … More
1635: Would you do an IOL exchange?
Let’s say that you have a patient who already had cataract surgery more than a year ago. At that time … More
1631: Marfan Case with Yamane IOL
In cases where the surgeon performs Yamane intra-scleral haptic fixation (ISHF) it is recommended that at least a partial anterior … More
1629: can you show more Tecnis cases?
A number of ophthalmologists have asked if I can show more cases using Tecnis IOLs and I am happy to … More
1619: high power IOLs for radial keratotomy
Over the course of decades, we have found that radial keratotomy (RK) keeps flattening the cornea. Initially these previously myopic … More
1617: minus power IOLs – meniscus
This patient is so extremely myopic that the IOL power is -2.0 diopters (minus power) in order to leave the … More
1610: poly-pseudophakia 2 IOLs in 1 eye
Nanophthalmic eyes are among the most challenging when it comes to cataract surgery. There are additional risks and the working … More
1608: different ways to explant IOLs
99% of the time the IOL implanted at the time of cataract surgery is the one that the patient will … More
1607: Z-suture technique to secure IOLs
There are so many innovative techniques in ophthalmology, that it is quite a challenge to learn all of them. This … More
1593: this EDOF patient will be amazed
What are the factors for success with EDOF (extended depth of focus) IOLs? How can we ensure that the patient … More
1587: IOL scaffold technique
The IOL scaffold technique is where the IOL is implanted prior to removal of the last bits of the cataract. … More
1547: Quiz: Why is the IOL decentered?
Look carefully at the picture and see if you can determine why the IOL is decentered? The capsulorhexis looks good … More
1522: pupil size affects EDOF IOL vision
As surgeons, we know that the refractive outcome for each patient depends on our surgical technique, the calculations, the technology, … More
1511: explanting the bag + IOL + CTR
This patient has late dislocation of the entire capsular bag including the capsular tension ring (CTR) and the IOL. To … More
1488: Fuchs Dystrophy with EDOF IOL
In the past, I was reluctant to implant an EDOF (extended depth of focus) IOL in patients with corneal issues. … More
1483: challenging case of ectopia lentis
Our guest surgeon, Dr Guillermo Amescua, is an outstanding surgeon at the Bascom Palmer Eye Institute in Miami, Florida, USA. … More
1480: ASCRS case 11: reposition toric IOLs
Toric IOLs are great for treating significant degrees of corneal astigmatism and in the USA, we have a range that … More
1478: ASCRS case 9: upside down IOL
You may be surprised to learn that an upside down IOL happens to every single cataract surgeon. The key is … More
1477: ASCRS case 8: IOL exchange
There comes a time every so often when you will need to perform an IOL exchange. This is not as … More
1475: ASCRS case 6: re-fixating the IOL
When you have dislocation of the IOL or the entire IOL+capsular bag complex, what are the options for re-fixation? This … More
1468: great Yamane cases always do this
The Yamane technique of securing a three-piece IOL to the scleral wall is ingenious. It can work very well but … More
1422: IOL surgery for ectopia lentis
While having a dislocated crystalline lens is a rare occurrence, it can pose surgical challenges due to the lack of … More
1421: belt loop technique to secure IOLs
Our guest surgeon, Dr Cathy McCabe from Florida, USA has an innovative way of securing IOLs to the sclera in … More
1419: How to reposition a toric IOL
It is now months after the original cataract surgery and you examine your patient and realize that the toric IOL … More
1389: posterior capsulorhexis optic capture
Our guest surgeon performs cataract surgery for this 5 year old child with galactosemia and he uses pearls learned from … More
1386: IOL designed for scleral fixation
For patients with aphakia and an absence of zonular support, many surgeons recommend fixating the IOL to the sclera. This … More
1344: dislocated IOL and capsular bag
This patient presented to our teaching clinic with a history of blunt ocular trauma about six months prior. He stated … More
1318: trifocal IOL performance years later
In the USA we have had access to some trifocal IOLs for the last couple of years. During that time … More
1315: Update on the Tecnis Eyhance IOL
This video gives an update on my experience with the J&J Tecnis Eyhance monofocal IOL. It is a good monofocal … More
1304: EDOF IOL with Prior RK
You may be surprised when I tell you that I continue to learn more and more from making surgical videos. … More
1297: intra-scleral IOL haptic fixation
The three main ways of fixating a three-piece IOL to the sclera without using sutures: the Yamane technique, the Scharioth … 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
1291: IOL exchange segment bifocal IOL
Some may think that a segment bifocal IOL would have no sacrifices in visual quality compared to a bifocal (or … More
1289: how to re-center a Yamane IOL
The Yamane technique for fixation of a three-piece IOL to the sclera is a good option for a posterior chamber … More