Every cataract surgeon will encounter the complication of a dropped nucleus. This is to be expected even with perfect surgical … More
Category: pars plana vitrectomy
2013: cataract after pars plana vitrectomy
This patient had a pars plana vitrectomy for retinal pathology and then developed this central posterior capsule opacity shortly thereafter. … 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
1913: favorite technique for post PPV eyes
Prior pars plana vitrectomy (PPV) makes the cataract surgery more challenging because it removes the anterior hyaloid face and vitreous … More
1874: challenging rescue of a dislocated IOL
In this case, the IOL is falling back into the vitreous cavity and it is certainly entangled with the vitreous. … More
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
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
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
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
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
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
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
Cataract Surgery with Asteroid Hyalosis
Asteroid hyalosis is a rare condition where patients have calcifications throughout the vitreous jelly. It occurs in about 1-2% of … 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