The challenge in performing traditional phaco chop is that the probe tip has to hold the nucleus with vacuum while … More
Category: reader submissions
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
1757: Focus on Efficiency: please help me
This week we have a Focus on Efficiency. Today, a look at an experienced surgeon’s case. An anonymous ophthalmologist with … More
1713: pars plana tap for aqueous misdirection
The key to resolving iris prolapse is to release the pressure gradient and we have covered this topic many times … More
1709: save this run out capsulorhexis
This guest surgeon does a great job of managing this run out capsulorhexis. It extends all the way to the … More
1692: tailor your technique to your population
I am a strong advocate of learning all different techniques of phaco and nucleo-fractis because I want to have all … More
1684: displaced phakic IOL & endo loss
This patient had bilateral phakic IOLs implanted about a year ago to address a high degree of myopia. Now the … More
1678: can you chop with any instrument?
I have said it before, the hands are more important than the equipment. And the technique is more important than … 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
1670: traumatic cataract with iris damage
This patient sustained ocular trauma which resulted in a traumatic cataract, zonular loss, iris avulsion, and vitreous prolapse. Now you … More
1668: femtosecond laser fragmentation
We have covered the topic of femtosecond lasers in cataract surgery many times before. Most cataract surgeries performed in the … More
1667: case 2500 small pupil, no ring needed
Many surgeons will see this small pupil and immediate ask for a pupil expansion ring or iris hooks and that … More
1640: anterior capsule plaque peeling
Our guest surgeon presents a case of a dense cataract where the cortical lens proteins broke down and caused a … 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
1615: micro-cornea and coloboma
This is a very unusual case where the patient has a micro-cornea and also a coloboma with associated zonular absence … More
1614: PXF, shallow AC, DWC, zonulopathy
This is a tough case with many challenges: pseudo-exfoliation syndrome, a shallow anterior chamber, a dense white cataract (with intumescence), … More
1612: retrieval of a lost CTR
When implanting a capsular tension ring, particularly in a challenging case, there is always that tiny fear that it may … 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
1604: return to the OR for retained lens
A retained lens fragment is a relatively common occurrence after modern day cataract surgery. We are able to use small … More
1601: cataract skills after 1600 cases
Yesterday was video number 1600 which means that we have featured a new video/post every day for the past 1600 … 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
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
1583: pseudo-exfoliation with iris hooks
Our guest surgeon does a great job with this tough cataract case. The patient has an intumescent white cataract and … More
1582: Quiz: Why such an odd chopper?
Time for a Cataract Quiz: look at the picture here and tell me, why this surgeon is using such an … More
1579: phaco through small capsulorhexis
The double capsulorhexis technique is very useful for intumescent white cataracts because it allows us to safely decompress the capsular … More
1577: improvement after 100 surgeries
Our anonymous resident surgeon submitted a video of routine cataract surgery which we featured a few months ago as video … More
1576: three techniques of nucleus division
Our guest surgeon today is a young resident from Brazil who sent in a video showing him performing three different … More
1549: cataract surgery in angle closure
Cataract surgery in the setting of angle closure glaucoma is very challenging because the anterior chamber is very shallow, the … 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
1528: open globe, failed graft, & cataract
This video is a series of three separate surgeries on the same patient, by the same surgeon, Dr Jimmy Hu … More
1527: resorbed cataract with zonular loss
This patient sustained trauma to his eye years ago and that resulted in a cataract which, over time, became liquefied … More
1498: Wong hydration pocket incision
The Wong hydration pocket incision is an innovative way to help seal a corneal phaco incision. It involves creating a … More
1496: pearls for left handed surgeons
Should you hold the phaco probe in your dominant hand or non-dominant hand? Does it matter if you’re right handed … More
1493: stop-and-chop technique
Our guest surgeon does a beautiful job demonstrating the stop-and-chop phaco technique. We have featured this technique many times before … More
1492: suture the IOL to a prosthetic iris
This patient sustained severe ocular trauma which left the eye aphakic with no capsular support and also significant iris damage. … More
1491: creating a pupil for Axenfeld Rieger
Axenfeld Rieger syndrome is a rare condition where the iris and pupil do not develop correctly in utero and in … More
1490: large Descemet detachment
We all know how delicate the Descemet layer of the cornea is and also how easily it is damaged. Even … More
1489: corneal epithelial bubble
This patient developed a corneal epithelial bubble during cataract surgery. Why did this happen and what should you do now? … 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
1482: upside down IOL – who is at fault?
Watch this anonymous video very carefully and let me know who is to blame for this upside down IOL, the … More
1469: open sky cataract surgery
There are times where you will want to perform a combination surgery of full-thickness corneal transplant and cataract surgery at … More
1460: phaco without visco-elastic / OVD
Many decades ago when phacoemulsification was first presented to the world by Charles Kelman MD, no viscoelastic was used during … More
1458: phaco for a patient with tremors
I have previously featured a challenging cataract case for a patient with severe tremors due to systemic neurological disease. In … More
1457: small capsulorhexis leads to trouble
This is another case where the capsulorhexis is about 4 mm in diameter and this causes a complication where the … More
1456: operating through a small rhexis
Keep in mind the dimensions of the typical cataractous lens: about 9-10 mm in diameter and then about 4-5 mm … More
1455: cortex removal before nucleus removal
This video shows something that I have never previously seen before: removal of the lens cortex prior to removing three … More
1427: Let’s critique registrar case #50
This young ophthalmologist in training is a registrar in the UK and s/he has submitted an anonymous video for critique. … 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
1408: the posterior capsule is ruptured
Look carefully at the title picture and you will see that the posterior capsule is ruptured and it appears to … More
1399: four simultaneous camera angles
Our guest surgeon is Dr Andre Berger from Brazil and he is an accomplished, expert cataract surgeon. In this video … More