1173: phaco aspiration of lens milk

Intumescent white cataracts can pose a problem with capsulorhexis creation. This is because the cortex has liquefied and pressurized the … More

1168: rescue this descemet’s detachment

Descemet’s membrane is very delicate and it can become detached during surgery. The usual entry site is from one of … More

1163: phaco behind the corneal scar

When a corneal scar limits the visualization, how can you still complete the cataract surgery in a safe manner? And … More

1162: resident posterior capsule rupture

This resident experiences a posterior capsule rupture during phaco and there is still a lot of nuclear lens material in … 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

1159: Pre-Chopper Technique

The pre-chopper is an instrument that can be used to split a cataract prior to inserting the phaco probe. It … More

1158: adjusting the red reflex

The two primary illumination sources on your microscope are coaxial and paraxial. We have previously explained the differences in the … More

1157: Malyugin ring rips the lens capsule

This video shows a complication that I have never seen before: insertion of the Malyugin pupil expansion ring inadvertently rips … More

1154: posterior assisted levitation PAL

In this case the posterior capsule ruptures during hydro-dissection. With a wide open posterior capsule, the nucleus starts to descend … More

1151: white cataract and uveitis synechiae

This patient has a long standing history of uveitis which has resulted in synechiae between the iris and the anterior … More

1150: white cataract with iridoplasty

This patient was undergoing cataract surgery by a novice surgeon who ran into trouble right at the beginning of the … More

1149: posterior capsulorhexis technique

There are times when it is helpful to perform a posterior capsulorhexis. This is a tricky maneuver because it opens … More

1144: white cataract intra-capsular surgery

Decades ago the standard cataract surgery was an intra-capsular cataract extraction. This involved making a large incision, injecting alpha chymotrypsin … More

1143: why such a tiny capsulorhexis?

This is the double capsulorhexis technique which is a great choice for intumescent white cataracts. In these types of cases, … More

1140: IOL punch for suture fixation

There are many different techniques for suture fixation of an IOL to the sclera: Yamane, Canabrava, Gore-Tex, belt loop, and … More

1130: Pupil Expansion with B-Hex Ring

If you really want to be honest with yourself, you will agree that the B-Hex pupil expansion ring is amazing. … 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

1105: Using the Power Pre-Chopper

The Ultra-chopper was designed by Dr Luis Escaf in order to penetrate a very dense nucleus to chop a cataract. … More

1103: Pre-Chopper Technique

Pre-chopping means that we are splitting the nucleus into half or quadrants prior to inserting the phaco probe into the … More

1101: Infant Lensectomy Technique

While congenital cataracts are rare, they must be identified very early in an infant’s life and then often surgically treated. … More

1098: Quad Camera Angles in surgery

This video was sent to us from Dr Felipe Ribeiro and Dr Andre Berger from Brazil and it features the … More

1096: converting from phaco to ECCE

There are rare times when it becomes important to convert from phaco to manual extra-capsular cataract extraction. This is one … More

1092: Traumatic Cataract Zonular Loss

Our guest surgeon Dr Vipul Arora from India presents a case of a traumatic cataract with sectoral zonular loss. This … More

1091: Dense Cataract and Nystagmus

Our guest surgeon is Dr Érico Jun Oda from Brazil and he demonstrates an expert level cataract surgery in a … More

1084: toric planning for high astigmatism

Our video today showcases the surgical planning for this patient with a high degree of corneal astigmatism. We will go … More

1082: release of posterior synechiae

Our guest surgeon shows us his technique of using a spatula to release the posterior synechiae in this eye with … More

1081: if you need iris hooks, use them

Our guest surgeon shows us a case that really benefits from using iris hooks. This video goes into the details … More

1070: Posterior Polar Cortical Cleaving

I really enjoy watching surgical videos from Dr. Neto Rosatelli from Ribeirão Preto, Brazil because he mixes his high degree … More

1068: sutured capsular tension segment

This patient was born with a lens coloboma where part of the crystalline lens did not develop and there is … More

1067: Phaco and iStent Glaucoma device

Cataract surgery alone tends to lower intra-ocular pressure by as much as 25%, which is particularly helpful for patients with … More

1052: Spiral Out Capsulorhexis

Our video features a young and talented surgeon, Dr Priyanka Pantola from Kanpur, UP, India and she is showing us … More

1049: four flanged IOL suture fixation

We have seen a lot of innovation with regards to IOL fixation to the sclera. There is the Yamane technique … More

1046: fixing anterior capsule fibrosis

Our usual way of dealing with fibrosis of the anterior lens capsule is to use a sharp instrument such as … More

1045: suturing the IOL to the CTR

Our guest surgeon is Dr. Val Apostolov from Amsterdam and he demonstrates a technique that I have never seen before: … More

1044: sutured capsule support device

Our guest surgeon is Dr. Atul Khadane from Amravati, India and he demonstrates the use of the Assianchor (developed by … More

1043: intra-vitreal injection punctures lens

The most commonly performed ocular invasive procedure performed in the USA is the intra-vitreal injection, with many millions done per … More

1040: White Cataract Double Rhexis

Our guest surgeon is Dr. Manbir Singh from India and he is showing us a dense white cataract case with … More

1038: Recurrent Pterygium Surgery

Removing a pterygium from a virgin eye that has not had prior surgery is relatively straightforward. The pterygium can be … More

1035: First year in practice cataract

In keeping with our theme of learning from the cataract surgeries of young surgeons who are at the beginning of … More

1030: Your Surgical Skills at Case 300

Where should your surgical skills be after 300 cases? We have previously explained the learning curve for cataract surgery and … More

1029: First year in practice Cataract

Our guest surgeon showcases his stop-and-chop nucleo-fractis in a routine cataract surgery and his technique is excellent. He finished his … More

1026: suturing the IOL to the iris

Our guest surgeon shows us his technique for suturing an IOL to the iris in a patient with long-standing peudo-exfoliation … More

1025: Soemmering’s Ring Extraction

Our guest surgeon, Dr Val Apostolov from Amsterdam, is a frequent contributor to CataractCoach and today he shows us a … More

1024: SICS for uveitic cataracts

This is a case of a cataract with extensive synechiae due to prior uveitis. The eye is quiescent now, with … More

1023: Foreign body capsule rupture

This patient sustained a serious ocular injury: a foreign body pierced the cornea, punctured the anterior lens capsule, and now … More

1022: Suprachoroidal hemorrhage

A suprachoroidal hemorrhage is a dreaded complication that can happen with any intra-ocular surgery. We most commonly see it during … More

1010: Bimanual Phaco Technique

About 15 years ago, bimanual phaco was relatively popular. The idea is that by separating the infusion from the aspiration, … More

1008: Horizontal Chop Technique

Our guest surgeon is Dr Hafidi Zouheir from Rabat, Morocco and he expertly demonstrates the horizontal chop technique for a … More

1001: Ahmed Glaucoma Valve Technique

Our guest surgeon today is Victoria Tseng, MD, PhD who is a glaucoma specialist and professor at the Jules Stein … More

I wish I had this book in residency!

“What your medical school and ophthalmology textbooks can’t teach you, but what your mentors, colleagues, and patients will!” That really … More

Capsular Tension Ring Placement

Our guest surgeon is Dr. Bhagyashri Deshmukh from Amravati, India and she is presenting a traumatic cataract case with a … More

Anterior Chamber Phakic IOL removal

Phakic IOLs are useful to address extreme degrees of myopia, but there are potential complications. Previously, we have featured cases … 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

Pseudo-Exfoliation White Cataract

Our guest surgeon today is a young ophthalmologist from Spain and he is performing phaco for a patient with a … More

Cataract, cornea transplant, glaucoma tube

Our guest surgeon is Guillermo Amescua MD who is a faculty member at the Bascom Palmer Eye Institute in Miami. … More

Recovering from an anterior capsule rip

We have extensively covered the topic of white cataracts here on CataractCoach and we have an entire subcategory devoted to … More

Cataract Quiz: Zonular Dehiscence

Our guest surgeon is Dr Willie Kan from Malaysia and he presents a very tough case: a traumatic white cataract … 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

anterior segment total reconstruction

This is a very complex case of a patient who had cataract surgery elsewhere and sustained complications during the procedure. … More

double flange IOL scleral fixation

The Yamane technique of IOL fixation to the scleral works better with certain three-piece IOLs because of the differences in … More

Capsule Break with I/A and rescue

Our guest surgeon today is Dr Ahmed Al Habash who shows us the best technique of dealing with a posterior … More

Punctured Posterior Capsule Rescue

There are two types of ophthalmologists who do not ever have surgical complications: those who do not operate and those … More

Guest surgeon: Milky White Cataract

Our guest surgeon today is Dr Pooja Bhomaj from Miraj, India and she presents a case of a milky white … More

Benchmark: Skills after 1000 surgeries

Our guest surgeon today is Érico Jun Oda MD from Brazil and he is showing us a routine cataract case. … More

Femtosecond Laser White Cataract

Our guest surgeon today is Xiongfei Liu MD from Sacramento, California. He was previously a resident with us at our … More

White Cataract Double Capsulorhexis

It is always a pleasure to learn from a master surgeon like Dr Pradip Mohanta from West Bengal, India. He … More

Capsular tension rings in PXF

capsular tension rings (CTR) in pseudo-exfoliation (PXF) cataract surgery

Soft versus Dense Cataracts

Our guest surgeon, Dra. Luz Marina Melo from Colombia, shows us two very different techniques for soft versus dense cataracts. … 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

expert white cataract capsulorhexis

CataractCoach has advised the beginning surgeons to improve the dexterity of the non-dominant hand and this case is a great … More

Cataract Quiz: What happened here?

Our quiz features a video from Gustavo Hüning, MD, MBA from Brazil and it shows an unusual situation that happens … More

Rotary Chop Technique

The key to splitting a brunescent cataract is to access the central endo-nucleus. This is the densest part of the … More

Phaco Chop without Vacuum

It is a pleasure to watch an expert surgeon doing cataract surgery and I really enjoyed learning from Dr. Alex … More

recovering from Argentinian Flag Sign

We have explained in great detail the techniques that can help to prevent the dreaded Argentinian flag sign with intumescent … More

Cataract Quiz: Trapped Air Bubble

We have a great learning case from Dr. Xiaogang Wang from Taiyuan, China with a surgical challenge. This patient has … More

Drill and Chop Technique

With a dense cataract, more effort and force is needed to chop the cataract. Usually with phaco chop, it is … 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

Challenge: Monocular Dense Cataract

Operating on a monocular patient is always stressful since we know that the stakes are higher due to the patient … 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

Glaucoma Drainage Implant Technique

I have learned so much from the video submissions that we receive at CataractCoach. It makes me wonder how I … More

Intumescent Cataract Auto Aspiration

We know that intumescent white cataracts can be challenging because the lens capsule is pressurized with liquefied lens cortex. This … More

Mastering Stop-and-Chop phaco

Stop-and-chop is a common technique in phaco cataract surgery because it is safe, efficient, and relatively easy to learn. We … More

Safety with Cannula Use – be careful!

Beginning surgeons do not always realize that the force created by using small 27g cannulas can be quite high. If … More

Lateral Phaco Chop Technqiue

With traditional phaco chop, we place the chopper in front of the phaco probe tip, but there are other options. … More

Capsulorhexis Pearls

By watching many surgeons, we can learn different ways of performing the same procedure. In this case, Dr Luis Escaf … More

Peeling Capsular Membranes

We present another great learning video from Dr. Val Apostolov from Amsterdam, The Netherlands to show the techniques of peeling … More

Bare Sclera Pterygium Surgery

There are many ways to do the same surgery and the best option is for us to learn about all … More

Fibrotic Dense White Cataract

This patient developed a white cataract years ago and was unable to seek treatment for a prolonged period of time. … More

Uveitic Dense White Cataract

This dense white cataract is further complicated by being an a uveitic eye with a fibrotic membrane causing a small … More

Resident Case: improve white cataract chop

In this anonymous video from a resident in Germany, we look to improve the horizontal chop technique in a dense … More

Resident Case: improve stop-and-chop

In this anonymous video from a resident in the USA, we look to improve the stop and chop technique. This … More

Resident Case: improve tilt and chop

In this anonymous video from a resident in Argentina, we look to improve the tilt and chop technique. This young … More

Resident Case: improve vertical chop

In this anonymous video from a resident in India, we look to improve the vertical chop technique. This young surgeon … More

Resident Case: improve horizontal chop

In this anonymous video from a registrar (resident) in the UK, we look to improve the horizontal chop technique. This … More

Resident Case: improve flip and chop

In this anonymous video from a resident in South Korea, we look to improve the flip & chop technique. This … More

Expert Surgeon versus The Rock

There is so much to be learned by watching other surgeons operate. Even after so many thousands of cataract surgeries … More

Which resident will win this contest?

Residents often prefer to learn divide-and-conquer as the first nucleo-fractis technique for phaco surgery. This requires making a central groove … More

Draining a choroidal hemorrhage

We recently featured a video of a sudden choroidal hemorrhage which happened during implantation of an IOL. This is a … More

Mastering Divide-and-Conquer

Most young ophthalmologists start learning phacoemulsification cataract surgery with the divide-and-conquer technique. This is an easier technique to learn than … More

Pediatric Posterior Capsulorhexis

Our guest surgeon is Ike K. Ahmed MD from the Prism Eye Institute in the greater Toronto area. He is … More

Dense Cataract Vertical Chop

For a dense cataract, the vertical chop technique works well because the chop will propagate through the nucleus. We have … More

Spiral Capsulorhexis Technique

After needle decompression of the cataract, using a spiral technique for the capsulorhexis has a distinct advantage: if there is … More

Submarine Chop for dense cataracts

For a dense cataract, performing phaco chop is challenging because the central lens nucleus is so hard that the chop … More

White cataract needle decompression

We know that an intumescent white cataract is fluid-filled with liquefied lens cortex. This makes the pressure within the capsular … More

Small incision glaucoma surgery

This video is amazing — when I first saw this technique, I was in awe because I learned so much. … More

Residual posterior polar opacities

We love to show posterior polar cataract videos and we have an entire category for them here on CataractCoach. Using … More

Small pupil, PXF, and IFIS

For a beginning surgeon it is helpful to see surgeons performing techniques that are out of your comfort zone. The … More

Expert level dense white cataract surgery

It is a pleasure to watch a true expert perform his craft and this is especially true for cataract surgery, … More

Fixing severe capsular phimosis

In a small number of patients, capsular phimosis can happen after cataract surgery. This can lead to severe distortion of … More

Resident Cataract Surgery Final Exam

Today is June 30 and that is the final day of residency training in the USA since our academic year … More

Fluidic Analysis during Phaco Chop

It can be helpful to see the machine fluidic parameters in real-time as the phaco chop procedure is performed. We … More

2 approaches to Posterior Polar Cataracts

Studies have shown that 1 out of 3 posterior polar cataract surgeries result in a ruptured posterior capsule. Here’s the … More

Pre-Chop with just 2 Choppers

Guest surgeon Dr Valentin Apostolov from Amsterdam shows us his technique for splitting a dense nucleus into small fragments before … More

Recovering from Argentinian Flag Sign

We have an entire section devoted to achieving success with white cataracts, including intumescent white cataracts. But even in expert … More

Cataract Surgery in MegaloCornea

This patient has a huge cornea with a diameter of about 14 mm and an equally large anterior segment including … More

Does cataract surgery pose a viral risk?

Our colleagues from the University of Toronto recently did an experiment to determine if cataract surgery poses a risk of … More

Pre-Chop Variations for Cataract Surgery

In this video, submitted by Dr. Yaun Lin from Casablanca, Morocco, we can learn multiple different variations of Pre-Chop. This … More

Expulsive Choroidal Hemorrhage!

This video is a MUST SEE! An expulsive choroidal hemorrhage is a rare complication than any cataract surgeon must be … More

Capsulorhexis forceps with ruler marks

Our guest surgeon is Dr. Ron J. Smith who has been instrumental in teaching cataract surgery at UCLA for the … More

Congenital Iris Coloboma Repair

We have another video from master surgeon Dr. Valentin I. Apostolov from Amsterdam. In this video he shows us his … More

Pupillary Cerclage Technique

In cases of chronic traumatic mydriasis, we can use sutures to reconstruct a pupil of a reasonable diameter. We have … More

Lens Snare Technique

More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to … More

How to recover from a capsule rupture

It happens to all surgeons, and it is much more common in beginning surgeons: rupture of the posterior capsule during … More

Cataract Quiz: When did the bag break?

In this anonymously submitted resident video, there is a break in the posterior capsule during cataract surgery. With the assistance … More

Pit Technique for Dense Cataracts

With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult. … More

Manual SICS with nucleus bisection

SICS is small incision cataract surgery, and it refers to a method of manual expression of the nucleus through a … More

Cataract Quiz: What happened here?

Look carefully at this picture: what do you see? There is a three-piece IOL in the sulcus and there is … More

You must learn this before finishing residency

The challenge of residency training is that you have just a limited time to learn surgery. You can read books … More

Posterior Polar without delineation

Posterior polar cataracts are unusual, but certainly every ophthalmologist will see these patients in their own clinics. While most surgeons … More

Resident Cataract Case #165 Evaluation

This video is submitted anonymously by a resident ophthalmologist who has completed 164 cataract surgeries so far. This case, his … 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

Can we use a Toric IOL in Keratoconus?

Toric IOLs have the ability to neutralize corneal astigmatism at the time of cataract surgery to improve vision for our … More

Severe Capsular Phimosis

Capsular phimosis occurs when there is severe contraction of the anterior capsular tissue which results in a shrinking of the … More

Tear Out of the Anterior Capsule

In this video, which was anonymously submitted, an experienced surgeon encounters a routine cataract case where the anterior capsule is … More

White Cataract with Fibrotic Lens Capsule

This video was submitted by an anonymous surgeon who is attempting this case early in the course of surgical training. … More

Guest Surgeon Phaco Chop Technique

One of the hallmarks of a good surgeon is the ability to learn from other surgeons. In this case we … More

Quiz: Why is this phaco chop going to fail?

Look at this photo carefully. We can tell that this phaco chop will fail and the nucleus will not be … More

Evaluation of Tilt-and-Tumble Phaco

An anonymous surgeon has submitted a video of the tilt-and-tumble phaco technique which tends to work well with milder degrees … More

Expert Level Divide-and-Conquer

Many surgeons like the divide-and-conquer technique and it is widely used here in the USA. For young surgeons, it is … More

Evaluation of a resident chop technique

This video was submitted by a resident in Asia who is still learning phaco and has upgraded to using the … More

Guest Surgeon: Phaco Chop Technique

This video was anonymously submitted by an experienced surgeon who wants us to analyze the phaco chop technique and give … More

Resident Stop and Chop Cataract #50

After doing 50 cataract surgeries, most beginning surgeons have developed good technique for the steps of the procedure. For surgeons … More