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

Should you use a trifocal IOL in Fuchs’?

This is an unusual case: the patient has Fuchs’ Corneal Dystrophy and yet we are implanting a trifocal IOL. Usually, … 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

Guest Surgeon PanOptix Tips & Tricks

In the USA, we often get access to new technologies later than other countries due to the hurdles required to … 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

Initial Review of the Alcon PanOptix IOL

The Alcon PanOptix IOL has been available in the USA for about three months. What are our initial impressions? How … 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

Alcon PanOptix Trifocal IOL Performance

In the USA, the FDA has recently approved the Alcon PanOptix IOL for use in cataract surgery. This is a … 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

Does age make a difference in IOL surgical planning?

We have some amazing surgical technology now with IOLs that give a wide range of vision and can even help … More

Switching from a Toric IOL to a spherical sulcus IOL

We recently featured a four-part series of a single, complicated cataract case in which the phaco probe punctured the posterior … 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

Dual Optic, Curvature Changing, Full Range Presbyopic IOL

Imagine an IOL for cataract surgery that mimics the human lens with the ability to give a wide range of … 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

This is why I do LRIs at the end of the case

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

Match the Phaco Incision to the Limbal Relaxing Incision

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

Some Simple Ophthalmology Mathematics

Ophthalmology has a large degree of math, particularly when it comes to refractive surgery.  Our most commonly performed and most … More

Surgically Treating Residual Astigmatism

Which do you choose: Limbal Relaxing Incision (LRI) or Laser Vision Correction (LVC) for treatment of residual astigmatism after cataract … More

Comparison of Night Vision with Different IOLs

Patients often ask me if any of the new lens designs will give them youthful vision. The truth is that … More