It is now months after the original cataract surgery and you examine your patient and realize that the toric IOL … More
Category: refractive surgery / refractions
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
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