Using a pupil expansion ring, like the Malyugin ring, can be helpful in some cases of a small pupil, but … More
Category: IOL related
2018: dislocated IOL replaced with ACIOL
Looking at this title pic, you can see a large degree of capsular phimosis. This progressive constriction of the capsulorhexis … More
2012: Gore-tex suture fixation of tilted IOL
This patient was pseudophakic and then sustained ocular trauma which resulted in zonular loss and a tilting of the IOL … More
2010: EDOF IOLs with Radial Keratotomy
Patients with prior radial keratotomy (RK) often have diurnal fluctuations in vision due to changes in the corneal hydration and … More
2004: understanding Aspheric IOLs
Today almost all of the IOLs that we use have an aspheric design with either negative spherical aberration or zero … More
1996: negative spherical aberration IOLs
I have a great educational video about spherical aberration and IOLs that is coming out in the next few weeks. … More
1984: IOL scaffold technique
We have featured the IOL scaffold technique before in cases where there is a posterior capsule rupture and the optic … More
1974: knot & flange technique to fixate IOL
When I first performed a sutured IOL about 25 years ago, it was suturing a CZ70BD IOL to the sclera … More
1962: effect of pupil size for EDOF IOLs
Just like the aperture (f stop) matters for taking photos with a camera, the pupil size plays a large role … More
1958: haptic disinsertion with Yamane IOL
The Yamane technique of scleral IOL fixation has grown in popularity over the years and it is a good choice … More
1957: challenging opacified IOL exchange
Rarely, IOLs will opacify with time with some designs more prone to this than others. In these cases we need … More
1954: Extended Depth of Focus IOLs
Choose the extended depth of focus IOL that will have best results with fewest compromises. The three main EDOF IOL … More
1921: retro-iris claw lens for aphakia
This patient has a complex ocular history which resulted in an eye with no capsular support. To address the aphakia … More
1898: IOL exchange with open capsule
There are times when an IOL exchange is the best answer for a challenging clinical situation and in this case, … More
1897: Anchor Style haptics for IOL fixation
This patient experienced a dropped nucleus during cataract surgery with extensive damage to the capsular bag. This poses a challenge … More
1863: technique of using Piggyback IOLs
Piggyback IOL refers to a second IOL that is placed in the eye so that there are now two lens … More
1844: ASCRS 2023 Course Case 4
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
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