Four handed phaco! What?

This is a case where we knew ahead of time there would be issues. The patient is mid 50s in … More

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

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

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