This is a case where we knew ahead of time there would be issues. The patient is mid 50s in … More
Category: resident surgeons
Descemet’s Membrane Detachment
When we make a corneal incision for cataract surgery, we must be careful to avoid damaging the attachment of Descemet’s … More
Recovering from an anterior capsule rip
We have extensively covered the topic of white cataracts here on CataractCoach and we have an entire subcategory devoted to … More
Never make an incision like this!
This is a resident case where the incision has terrible construction. The primary mistake is gliding the keratome along the … More
management of a dropped nucleus
This is a rare complication that can happen to any patient so the surgeon must know how to effectively manage … More
Combined Phaco + DMEK Surgery
Descemet Membrane Endothelial Keratoplasty (DMEK) has become the preferred surgical technique for the treatment of Fuchs’ corneal dystrophy. In the … More
Cataract Quiz: Why did this happen?
Looking at this picture, the pupil dilation went from 5 mm in diameter to 10 mm in diameter in just … More
MSICS in Pseudo-Exfoliation
It is important to learn how to perform MSICS: manual small incision cataract surgery. This is a more evolved and … More
Bad Incisions lead to trouble
This anonymous resident starts the case with a poorly placed and poorly constructed incision. It ends up bleeding, allowing blood … More
Crucial lessons learned in residency
A complication during surgery can be a mistake or it can be a lesson. The difference between them is that … More
Cataract Quiz: how to rescue this case
This patient has an intumescent white cataract and we know that poses a risk of capsular run-out due to the … More
warning: phaco wound burn!
This is among the most important cataract surgery videos that you will see in your lifetime. Really. I have taught … More
Review: Uveitis, Glaucoma, Cataract
Cataract surgery in an eye with uveitic glaucoma Stepwise approach to surgical success Cataract surgery in eyes with small pupils … More
Neo-vascular glaucoma Ahmed Valve FP7
When teaching our UCLA ophthalmology residents at our large county hospital, Olive View UCLA Medical Center, we encounter many patients … More
Surprise! Loose Zonular Support!
This patient has a dense cataract and a surprise waiting for the surgeon: as the nucleus is being cracked, we … More
great learning resident cataract case
If you are in an ophthalmology residency program in the northern hemisphere, particularly in the USA, then you know that … More
Is ophthalmology residency too difficult?
There is no doubt that ophthalmology residency training is more difficult now than it was 10 or 20 years ago. … More
Resident Cataract Case with Iris Hooks
For a small pupil case, using iris hooks is helpful to give better access during cataract surgery. This case is … More
Cataract Quiz: Why did the capsule rip?
This resident surgeon recently experienced quite a surprise: when he injected viscoelastic at the beginning of the surgery, the anterior … More
Resident Case: improve white cataract chop
In this anonymous video from a resident in Germany, we look to improve the horizontal chop technique in a dense … More
Resident Case: improve stop-and-chop
In this anonymous video from a resident in the USA, we look to improve the stop and chop technique. This … More
Resident Case: improve tilt and chop
In this anonymous video from a resident in Argentina, we look to improve the tilt and chop technique. This young … More
Resident Case: improve vertical chop
In this anonymous video from a resident in India, we look to improve the vertical chop technique. This young surgeon … More
Resident Case: improve horizontal chop
In this anonymous video from a registrar (resident) in the UK, we look to improve the horizontal chop technique. This … More
Resident Case: improve flip and chop
In this anonymous video from a resident in South Korea, we look to improve the flip & chop technique. This … More
Resident recovers from capsule break
In the course of learning cataract surgery, resident ophthalmologists will encounter complications such as this posterior capsule rupture. The key … More
Which resident will win this contest?
Residents often prefer to learn divide-and-conquer as the first nucleo-fractis technique for phaco surgery. This requires making a central groove … More
Cataract Quiz: Use the can-opener now?
During capsulorhexis creation, this resident surgeon loses control of the anterior capsule edge and it runs all the way out … More
How to: Challenging Uveitic Cataract
This patient has a long standing uveitis which is currently under control as well as uveitic glaucoma which required placement … More
Ruptured Globe: Key Teaching Points
Every ophthalmologist must know how to manage a ruptured globe. In this case it is a corneal laceration with a … More
resident divide-and-conquer case 30
An anonymous resident sent in this video of his/her 30th cataract surgery which was done with the divide-and-conquer technique. The … More
Review: Double Capsulorhexis for White Cataracts
Intumescent white cataracts pose a challenge because the lens cortex has degenerated so much that is has liquefied. This creates … More
Pars plana anterior vitrectomy
The only ophthalmologists who have zero surgical complications are those who don’t operate and those who are not fully truthful. … More
Review: fixing beginner mistakes
Learning intra-ocular surgery is not easy and it can take years just to be comfortable with just the basics. Look … More
Analysis of Resident Surgery Steps
This video features side-by-side double camera angles so that we can simultaneously see the microscope view as well as the … More
Resident Case Double Camera Angles
For experienced surgeons (which I define as those who have done at least a few thousand cataract surgeries), the microscope … More
Resident surgeon does case #100
For all of our young surgeons who are learning cataract surgery, this is a great video because it shows you … More
resident toric IOL case double camera angles
Using double camera angles can help newer surgeons learn the nuances of surgery. This video shows a resident surgeon who … More
Tough cataract case for a resident
We are thankful for the many video submissions we receive from our readers, particularly from residents or registrars who are … More
Enlarge the Capsulorhexis
A small capsulorhexis makes nucleus removal more difficult, especially when we have a dense cataract. When the entire lens hardens … More
Cataract Quiz: What do you do now?
This is a complication that is sure to happen to every beginning cataract surgeon: a broken posterior capsule as a … More
Newbie Resident Cataract Surgery
Even experienced surgeons can learn by watching novice surgeons operate. A nickname for a novice is a newbie since the … More
Cataract Quiz: Chopper breaks zonules
The resident surgeon has good hands and is talented, but like all new surgeons, he is lacking in experience. The … More
Posterior capsule rupture – finish the case
This resident case is a challenge: the posterior capsule is ruptured but there is still cortex to be removed. Can … More
Benchmark: Senior Resident Chop
This is a good benchmark for what a senior resident should be able to achieve by the end of residency … More
Resident Surgeon Stop-and-Chop
This is an anonymously submitted video of a resident performing cataract surgery number 60 and the technique is stop-and-chop. This … More
Secret to Chopping Dense Cataracts
For the phaco chop technique, the nucleus is held stationary by the vacuum level of the phaco probe. This is … More
Cataract Quiz: What’s your next move?
You are performing routine cataract surgery and then you suddenly notice that the posterior capsule is open and a nuclear … More
How to recover from a capsule rupture
It happens to all surgeons, and it is much more common in beginning surgeons: rupture of the posterior capsule during … More
Cataract Quiz: When did the bag break?
In this anonymously submitted resident video, there is a break in the posterior capsule during cataract surgery. With the assistance … More
Do not withdraw infusion with a capsule break
If there is a break in the posterior capsule, withdrawing the infusion will allow the anterior chamber pressure go to … More
Glaucoma Seton Drainage Surgery
In cases of intractable glaucoma, implanting a seton drainage device can be a very effective therapeutic option. The seton tube … More
How to Evacuate this Hyphema
This patient was struck in the eye with a Champagne cork, which was traveling at a high velocity and hit … More
How to Rescue this Capsulorhexis
We have previously discussed the Little Maneuver which is a method of saving a run away capsulorhexis. In this case, … More
Danger: Clear Crescent Red Reflex
When you are mobilizing a dense nucleus and you briefly see a bright, clear, crescent-shaped red reflex, you can be … More
Cataract Quiz: What happened here?
Look carefully at this picture: what do you see? There is a three-piece IOL in the sulcus and there is … More
You must learn this before finishing residency
The challenge of residency training is that you have just a limited time to learn surgery. You can read books … More
Posterior Capsule Rupture! Now what?
In this anonymously submitted case from a resident surgeon in training, there are many great lessons to be learned. We … More
Review: Posterior Capsulorhexis Technique
If there is a central posterior capsule plaque that cannot be removed with the suction from the irrigation/aspiration probe, we … More
Resident Cataract Case #165 Evaluation
This video is submitted anonymously by a resident ophthalmologist who has completed 164 cataract surgeries so far. This case, his … More
Cataract Quiz: What is the problem here?
Time for another Cataract Quiz. Look carefully at the photo — the IOL has just been implanted and now it … More
The surgeon will struggle to finish. Why?
In this resident surgeon case, the anterior chamber flattens and there is loss of viscoelastic upon attempted manipulation of the … More
Peeling off a Pupillary Membrane
In this complex case, there is a nearly complete pupillary membrane in an eye with a cataract and a prior … More
Cataract Quiz: Why did we get bleeding here?
In this resident case, the IOL is in the capsular bag, the capsulorhexis is intact, the viscoelastic has been removed … More
Phaco Incision Do-Over
In this case, the resident begins by making a phaco incision that is not good. The roof is too thin … More
Recovering from a radialized capsulorhexis
Learning to perform a consistent capsulorhexis is one of the toughest steps of cataract surgery. The anterior capsule is only … More
List of Key Videos for Residents
A young doctor in training asked me to put together a list of key videos prior to her first day … More
Resident Surgeon Learning to do Phaco Chop
In your quest to learn phaco chop, it is helpful to watch other beginning surgeons perform the same technique. In … More
Traumatic Cataract with Mydriasis: Part 2 Pupilloplasty
This patient suffered severe trauma as the result of an airbag injury from a car accident about one year ago. … More
Traumatic Cataract with Mydriasis: Part 1 cataract surgery
This patient suffered severe trauma as the result of an airbag injury from a car accident about one year ago. … More
White Cataract with Fibrotic Lens Capsule
This video was submitted by an anonymous surgeon who is attempting this case early in the course of surgical training. … More
Mastering Divide-and-Conquer Phaco
Back by popular demand! Most beginning surgeons start by learning divide-and-conquer as the primary method of nucleus division for cataract … More
Do you really want to learn surgery?
This is one of the most important videos that I have ever made. If you only watch one of my … More
Left-Handed Phaco: What is different?
In this video we review the differences between right-handed phaco and left-handed phaco. As expected, the instruments are held differently, … More
Evaluation of a resident chop technique
This video was submitted by a resident in Asia who is still learning phaco and has upgraded to using the … More
How to sculpt a nuclear groove
Sculpting a groove in the nucleus is required for techniques such as divide-and-conquer and stop-and-chop. The groove works best when … More
Resident Stop and Chop Cataract #50
After doing 50 cataract surgeries, most beginning surgeons have developed good technique for the steps of the procedure. For surgeons … More
Cataract Surgery Draping is Critical
Watching amazing intra-ocular acrobatics during a challenging cataract case is exciting and makes for a great video, but those cases … More
Close Up: Technique for Phaco Incision
We have shown many videos about the importance of the phaco incision. It is part of the signature that you … More
Capsulorhexis technique with just forceps
In more than 99% of my cataract surgery cases, I do not use a cystotome to start the capsulorhexis. I … More
Surgeon Ergonomics for Ocular Surgery
As an ophthalmic surgeon, you will spend a large part of your future in the operating room performing delicate ocular … More
How to Save this Run-Out Capsulorhexis
This case is performed by a junior resident who has done about 20 cases so far. The trouble starts when … More
Lysis of Synechiae and Capsule Staining under Iris
This patient had a prior episode of anterior segment inflammation which caused synechiae to develop, with adhesion of the iris … More
Quiz: Why does this pupil look irregular?
This patient is undergoing a combined cataract surgery with a pars plana vitrectomy. Two novice surgeons are operating: a senior … More
Combined Phaco + MIGS for cataract + glaucoma
Cataract surgery alone is a powerful technique for lowering intra-ocular pressure, particularly in patients with glaucoma. By replacing the 4+ … More
Resident Double Capsulorhexis for White Cataract
We know that intumescent white cataracts have a pressurized capsular bag with the milky white, liquefied cortex material. And we … More
Quiz: What is going on with this IOL haptic?
The surgery has gone very smoothly and the senior resident is doing a great job. The incisions are good, the … More
Resident Surgeon takes on a Dense White Cataract
It is a pleasure to show you this video where one of my senior residents performs and excellent cataract surgery … More
Slow motion analysis of posterior capsule rupture
Watching surgical video of cases is very helpful to understand the how and when of the complications of cataract surgery. … More
Quiz: What is the huge danger seen in this photo?
This surgery is being performed by a senior resident and it starts off great. It is a dense white cataract … More
Novice surgeon performs cataract surgery
This video was anonymously submitted by an ophthalmology trainee outside of the USA. He has completed about 90 cataract surgeries … More
Analyzing a resident Stop-and-Chop case
Most of the uncut surgical videos that are shown here are very efficient and complete cases can be performed in … More