Just like the aperture (f stop) matters for taking photos with a camera, the pupil size plays a large role … More
Category: refractive surgery / refractions
1961: review of limbal relaxing incisions
As an ophthalmic surgeon, you promised yourself that you would learn to perform limbal relaxing incisions (LRIs) to help address … More
1954: Extended Depth of Focus IOLs
Choose the extended depth of focus IOL that will have best results with fewest compromises. The three main EDOF IOL … More
1947: McDonald PRK technique & meds
Dr Marguerite McDonald’s special technique and medication regimen for PRK laser vision correction
1912: Refractive Lens Exchange High Myopia
We can agree that a refractive lens exchange is a good way to address high hyperopia in presbyopic patients, but … More
1861: curriculum lesson 25: refractive cataract surgery
The final lesson in our 25 part curriculum series is focused on refractive cataract surgery. You can see the entire … More
1829: top 5 pearls for presbyopic IOLs
Presbyopic IOLs, primarily trifocal designs, can make patients very happy. However there are some important considerations in order to achieve … More
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
1794: Eyhance OD and Vivity OS – why?
This patient is a physician from the east coast of the USA (more than 3000 km from my clinic) who … More
1790: Art of Refractive Cataract Surgery
Cataract surgery is so much more than just clearing the visual axis of opacities! Cataract surgery is our most powerful … More
1776: refractive lens exchange for hyperopia
For patients over age 60 with significant degrees of hyperopia, a refractive lens exchange (RLE) tends to be the preferred … More
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