For patients over age 60 with significant degrees of hyperopia, a refractive lens exchange (RLE) tends to be the preferred … More
Category: refractive surgery / refractions
1750: paired incisions for astigmatism
Doing refractive cataract surgery is becoming the norm with patients desiring correction of refractive errors at the same time as … More
1685: Primer on how to perform LASIK
Best pearls for learning to perform LASIK
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
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
1658: IOL calc case study 10: amblyopia
We often have patients with a history of amblyopia who are now presenting for cataract surgery. The cause of the … More
1647: do you trust intra-op aberrometry?
The idea behind intra-operative aberrometry is great: measure the eye in the aphakic state and then you can determine the … 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
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
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
1479: ASCRS case 10: topo & tomography
How do you make a surgical plan to correct astigmatism when the keratometer, topographer, and tomographer show differing degrees and … More
1432: high myopia refractive targeting
There is a reason why I recommend that you do NOT aim for a plano outcome in highly myopic eyes. … More
1429: refractive lens exchange pearls
In my quest to give away every secret, surgical pearl, and useful bit of knowledge that I have acquired over … More
1426: techniques for SMILE laser vision
Our guest surgeon is an expert in Small Incision Lenticule Extraction (SMILE) laser vision refractive surgery and has performed thousands … More
1419: How to reposition a toric IOL
It is now months after the original cataract surgery and you examine your patient and realize that the toric IOL … More
1357: biometry for trifocal IOLs
The new generation of diffractive trifocal IOLs such as the Alcon PanOptix and the J&J Tecnis Synergy are able to … More
1338: small incision lenticule extraction
Corneal refractive surgery for myopia is done by removing some of the corneal stroma in order to flatten the central … More
1307: the future of refractive surgery
Cataract surgery is our most powerful refractive procedure and it can correct extreme degrees of hyperopia and myopia, and it … More
1304: EDOF IOL with Prior RK
You may be surprised when I tell you that I continue to learn more and more from making surgical videos. … More
1259: OSN NY differing astigmatism
This talk is one of my lectures from the OSN NY 2021 meeting. This is the Ocular Surgery News meeting … More
1258: OSN NY managing capsular issues
This talk is one of my lectures from the OSN NY 2021 meeting. This is the Ocular Surgery News meeting … More
1255: does rhexis morphology matter?
Does the shape of the capsulorhexis matter? We are accustomed to making a 5 to 5.5 diameter capsulorhexis that is … More
1251: re-aligning a toric IOL without OVD
Our guest surgeon, Dr Alex Abdo Martins from Brazil, has a very interesting case for us. This patient has a … More
1227: secrets for radial keratotomy patients
While radial keratotomy (RK) is rarely used as a refractive surgery today, a few decades ago it was very popular. … More
1218: J&J Eyhance versus Alcon Vivity
Many surgeons have asked me to make a video comparing the J&J Eyhance to the Alcon Vivity IOL. I have … More
1208: center IOLs with Purkinje images
For monofocal IOLs, a small amount of IOL decentration will have a minimal effect, particular in IOLs with low or … More
1202: pearls for your first LASIK surgery
It is important to learn LASIK and other forms of refractive surgery during residency training. When I was a resident … More
1182: the J&J Tecnis Eyhance IOL
I am thankful to the engineers who continually improve our surgical products through technical advances. These engineers are usually smarter … More
1174: picking the right IOL for each eye
We are fortunate to have a wide range of different IOLs to offer our patients. We have bifocal IOLs, trifocal … More
1136: Refractive Lens Exchange Surgery
For high degrees of hyperopia in presbyopic patients, the best surgical solution is refractive lens exchange. For a younger patient, … More
1075: Can I use EDOF with eye disease?
I am frequently asked if the new class of EDOF (extended depth of focus) IOLs can be used in eyes … More
1063: Who is the ideal trifocal patient?
Of course, it goes without saying that you must have a normal cornea, retina, and optic nerve to even be … More
1062: Playlist: Refractive Issues
The most powerful refractive surgery that we have is cataract surgery. We can address +10 diopters or more of hyperopia, … More
1056: Let’s talk about my OR cases
Recently, on my usual Beverly Hills cataract surgery day, I had a line-up of a bunch of interesting cases and … More
1050: complete case: Toric EDOF IOL
This patient is a young man, in his 40s, with a history of cataract development over the last few years. … More
1037: Trifocal IOL with white cataract
Trifocal IOLs require refractive accuracy. We need to be able to deliver close to a plano outcome without much residual … More
highly myopic cataract surgery
These are some of the most rewarding cataract surgeries to perform since we can correct the cataract as well as … More
considerations for monocular patients
Monocular patients present a special situation that can differ from a routine case in a patient with two eyes. We … More
Extended Depth of Focus: Alcon Vivity
We all want to be young again, at least when it comes to vision: visual quality, range of vision, and … More
refractive lens exchange for hyperopia
This 58 year old patient is highly hyperopic, wearing +8.5 D glasses for distance vision and then +11.0 D glasses … More
Double Phaco Incisions to fix Astigmatism
double phaco incisions for treatment of astigmatism
PanOptix IOL in a Highly Myopic Patient
most extreme PanOptix IOL power for extreme myopia
Incisional Techniques for Astigmatism
Cataract surgery can be our most powerful refractive surgery procedure, correcting high degrees of myopia, hyperopia, and even astigmatism (with … More
choosing refractive targets
Plano is not always the goal It would seem logical that emmetropia is the ideal refractive state of the eye. … More
Cataract Surgery with prior Amblyopia
The most common causes of amblyopia are related to either strabismus or an untreated refractive error, particularly in one eye … More
Angle Alpha and Angle Kappa with IOLs
If an IOL has zero power, such as in an extremely myopic patient, where we place it in the eye … More
Cataract surgery & decentered LASIK flap
We frequently have patients with a history of prior LASIK who are now undergoing cataract surgery. We have explained in … More
Paired Incisions to fix Astigmatism
This is an easy technique that can be so helpful to all cataract surgeons. By using paired phaco incisions, we … More
Review: Cataract surgery after prior RK
This patient was very myopic and desired surgical correction many years before the advent of the excimer laser. As such, … More