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

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

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

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

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

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

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

Review: Why LRIs should be done at the end

Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract … More

Ensuring accuracy of A-scan ultrasound

Correlate A-scan & biometry measurements to improve accuracy in IOL calculations. This case shows how disparate measurements can lead to … More

Artificial Intelligence in Ophthalmology

The future is here and John Ladas, MD, PhD gives us a brief lecture about the Rules of the Game … More

Toric IOL Alignment Dilemma

In this picture, all of these lines are at the 120 degree meridian, so how do you choose where to … More

Cataract Quiz: Where should you make the incision?

Our phaco incisions will induce an astigmatic change in the cornea and we can use that to help achieve a … More

The patient has a surprise for you…

You have scheduled a patient for cataract surgery and the case seems relatively routine. The biometry was good and the … More

Review: IOL calcs in high hyperopia

Here is your challenge. You’re operating on a patient who is highly hyperopic (wearing +6.50 OD and +7.00 OS for … More

Simplified Technique for LRIs

Limbal relaxing incisions (LRIs) are a great option to treat pre-existing corneal astigmatism at the time of cataract surgery. They … More

Post-LASIK IOL Power Estimation

In eyes with prior LASIK, many different methods of IOL power estimation have been described to get more accurate results … More

Quiz: Why is the vision 20/200?

This patient has a pre-op visual acuity of just 20/200 but the cataract does not look that bad. Also, we … More

How to do Limbal Relaxing Incisions

Just about any incision in the cornea will induce some astigmatic change. We have shown how to place the phaco … More

Paired Phaco Incisions to Treat Astigmatism

Cataract surgery is our most powerful refractive procedure based on the spherical power that we can correct. Anything from –30 … More

Toric IOL with intra-operative aberrometer use

Guest Expert John Hovanesian MD implanting a Toric IOL with aberrometer guidance Dr. Hovanesian is a well-known and much respected … More

Review: Temporal vs Superior Phaco Incisions

Some surgeons prefer to make a superior phaco incision while others prefer a temporal approach. Is there a substantial difference … More

Evaluating Radial Keratotomy for Cataract Surgery

Radial keratotomy (RK) is an out-dated kerato-refractive surgery where radial incisions were made in the cornea in order to cause … More

Doing Cataract Surgery on a Cataract Surgeon

It is always an honor when fellow ophthalmologists ask you to perform their cataract surgeries. It can also be stressful … More

Review: Phaco Incision paired with LRI for Astigmatism Correction

We know that the phaco incision will cause some degree of corneal flattening and this has the ability to alter … More

For ultra high myopes, do not aim for plano!

For patients with a large degree of myopia, undergoing cataract surgery can be life changing because in addition to fixing … More

Pearls for Using Multi-focal IOLs (bifocal, trifocal)

For now, among the more reliable ways to address presbyopia is implanting a multi-focal IOL. These are typically diffractive in … More

Cataract Surgeons are Refractive Surgeons

Cataract surgeons are certainly refractive surgeons and we can correct large degrees of myopia, hyperopia, and astigmatism during our lens-based … More