1825: the problem with one haptic in the sulcus

This patient has femtosecond laser assisted cataract surgery with placement of a trifocal IOL two years ago. And while the … More

1775: the IOL is sitting on the macula

This patient suffered late dislocation of the IOL+capsular bag complex and it fell into the vitreous cavity and it now … More

1767: an amazing rescue of a tough case

Our guest surgeon, Dr Steve Safran has become an expert in complex re-operations and anterior segment reconstruction, with countless cases … More

1697: what is this loose Gore-Tex suture?

Our guest surgeon, Dr Sara Bozorg, has sent us a very interesting case. This patient had some unknown procedure performed … More

1689: phaco & pars plana vitrectomy

This patient has a rhegmatogenous retinal detachment as well as a visually significant cataract. Our guest surgeon is experienced with … More

1686: dense cataract iris & zonular loss

This case is beyond 10 out of 10 in difficulty and our guest surgeon, Dr Steve Safran, is a true … More

1586: bringing the dropped nucleus up

If the posterior capsule ruptures and the nucleus drops during cataract surgery, my advice to you is to let it … More

1560: IOL calc case study 3: prior PPV

Patients will have accelerated cataract development after a pars plana vitrectomy, and these patients will be sent to you for … More

1554: traumatic cataract and macular hole

The eye is a very fragile organ and trauma can cause dramatic damage that can be challenging to repair. We … More

1542: tough resident cataract case

This is a very tough resident cataract case and there are some complications. The most important point is that the … More

1484: phaco before vitrectomy surgery

This patient has visually significant cataracts in both eyes and a full-thickness macular hole in one eye. I have already … More

1381: please do not fish in the vitreous

When a posterior capsule rupture is encountered during cataract surgery, an anterior vitrectomy often needs to be performed to remove … More

1375: cataract with silicone oil droplets

This complete cataract case features a patient who underwent a prior pars plana vitrectomy for a retinal detachment and then … More

1361: dislocated microspherophakia

While microspherophakia is a relatively rare condition, we have featured it here previously including a resident case. This case is … More

1327: nanophthalmic eye with flat AC

Our guest surgeons today teamed up to help complete this cataract surgery in a nanophthalmic eye. The axial length is … More

1325: Lens Iris Diaphragm Retropulsion

LIDRS is lens iris diaphragm retropulsion syndrome and it occurs when the iris forms a seal around the anterior capsule … More

1299: cataract surgery in nanophthalmos

This patient has a very small eye with an axial length of just 15 mm. That makes the entire surgery … More

1236: IOL exchange & Yamane technique

The Yamane technique for IOL fixation to the sclera is an innovative way to secure a three-piece IOL in the … More

1211: white cataract drops into vitreous

Our guest surgeon presents a case of a surprise complication when the white cataract falls into the vitreous cavity. He … More

1161: IOL rescue suture fixation

Twenty years ago, the most common method of suturing an IOL to the sclera was using 10-0 prolene and a … More

1129: exposed and eroding IOL sutures

The best placement of an iOL is in the capsular bag. That is the end of the story. There are … More

1121: how it started… how it’s going…

There is so much to be learned from this case. The patient has advanced diabetic retinopathy and a significant cataract. … More

1073: Why did the AC Depth increase?

This patient had biometry performed in our clinic, using the same machine in 2017 and then again in 2021. Of … More

1014: Cataract after prior vitrectomy

This week we are doing complete cataract cases where we will show an entire surgery from start to finish and … More

Cataract with Silicone Oil Removal

Our guest surgeon is Willie Kan, MBBS from Malaysia and he is showing the technique of combined cataract surgery with … More

Four handed phaco! What?

This is a case where we knew ahead of time there would be issues. The patient is mid 50s in … More

chandelier lighting for cataract surgery

This patient has a non-clearing vitreous hemorrhage from proliferative diabetic retinopathy in addition to a cortical cataract. Our guest surgeon … More

management of a dropped nucleus

This is a rare complication that can happen to any patient so the surgeon must know how to effectively manage … More

Pars Plana Injection of BSS

Our guest surgeon, Dr Mohammad Abusamak from Jordan, is performing cataract surgery on this monocular patient who has a high … More

recovering from posterior capsule rupture

Every surgeon, no matter how experienced, will experience complications. The rate of complications such as posterior capsule rupture declines substantially … More

Equanimity under Duress

When Sir William Osler left the University of Pennsylvania’s Medical School (the first one in the USA, started in 1765) … More

Pars plana anterior vitrectomy

The only ophthalmologists who have zero surgical complications are those who don’t operate and those who are not fully truthful. … More

Two-Handed Capsulorhexis Technique

Our guest surgeon is Ravi Goel MD from New Jersey, USA who is also the author of the ProtectingSight.com blog. … More

Quick Fix for Reverse Pupillary Block

In myopic eyes and post-vitrectomy eyes, we can get an overly deep anterior chamber during cataract surgery. The infusion pressure … More

Flip and Chop in post-PPV eyes

With a prior pars plana vitrectomy, the anterior hyaloid face is gone and therefore there is less support for the … More

Opacities seen during cataract surgery

In this unusual case we see opacities in the red reflex during cataract surgery. Most of these are within the … More

Quiz: What is this focal lens opacity?

What is this focal lens opacity that is seen during cataract surgery? And how do we remove it? What likely … More

Quiz: what is different about this white cataract?

This patient has an intumescent white cataract but something is different about this case. In fact, there is a very … More

Quiz: Why does this pupil look irregular?

This patient is undergoing a combined cataract surgery with a pars plana vitrectomy. Two novice surgeons are operating: a senior … More

Pars Plana Anterior Vitrectomy can be very helpful

When the capsule breaks during cataract surgery and the vitreous prolapses into the anterior segment, it is important to clear … More

Pars Plana Anterior Vitrectomy & IOL Retrieval

While most cases of vitreous prolapse during a complicated cataract surgery can be effectively address via limbal incisions, there are … More

Cataract Surgery after Macula-Off Retinal Detachment

A macula-off retinal detachment usually means a more limited visual prognosis because the critical central vision has been permanently altered … More

Cataract Surgery in a younger patient with prior PPV

As we demonstrated recently, cataract surgery in a younger patient (under age 50) can be different than in the typical … More

Cataract Surgery and Pars Plana Vitrectomy

There are cases where a patient has both anterior and posterior segment pathology and doing both a cataract surgery plus … More

Phaco Flip in Post-Vitrectomy and Flomax Cases

Phaco flip has an advantage over other methods of nucleus division: the cataract is already partially out of the capsular … More

Should you try to rescue a dropped nucleus?

For most situations, I recommend that if the cataract nucleus drops into the vitreous cavity due to a ruptured posterior … More