Complete Cataract Case: the entire surgery is shown from start to finish, but don’t fret, it is still just a … More
Category: routine cases
Soft Chop technique for soft cataracts
With the amazing results from modern day cataract surgery, many patients are electing to experience the benefits of pseudophakia when … More
complete cataract case: optimize steps
Most of us will have the opportunity to perform thousands of cataract surgeries (often tens of thousands) during the course … More
complete case: chop nucleus in the bag
One of my favorite types of videos to watch is the Complete Cataract Case. I enjoy seeing a surgery from … More
Benchmark: Skills after 1000 surgeries
Our guest surgeon today is Érico Jun Oda MD from Brazil and he is showing us a routine cataract case. … More
Cataract Surgery for a Cataract Surgeon
cataract surgeon for a cataract surgeon
complete case: phaco chop in myope
Complete Cataract Cases are videos where we show the entire surgery, from the first incision (usually the paracentesis in my … More
Small Capsulorhexis Phaco Chop
The capsulorhexis is an important part of cataract surgery and one reason is that it allows access to the inside … More
a short groove is sufficient
For techniques such as stop-and-chop or divide-and-conquer, the phaco probe is used to sculpt a trench or groove in the … More
Complete Cataract Case: Routine Surgery
While it is fun to watch a video of a cataract surgery that involves complicated maneuvers and difficult challenges, this … More
Phaco Chop without Vacuum
It is a pleasure to watch an expert surgeon doing cataract surgery and I really enjoyed learning from Dr. Alex … More
Complete Cataract Case: No pupil ring!
Another video in our series of complete cataract cases, where the entire surgery from start to finish is presented. There … More
compilation video: perfecting your surgery
The difference between good and great may appear subtle to outsiders, but for ophthalmologists like us, these details are very … More
complete cataract case: great red reflex
We all love a great red reflex during cataract surgery because it makes is much easier to see details such … 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
complete cataract case: phaco flip
The key to the phaco flip technique is using the fluid wave from hydro-dissection to gently prolapse part of the … More
Cataract Quiz: Why is the cornea cloudy?
This is a routine cataract surgery case. It is very efficient and a minimal amount of ultrasound energy is used … More
Critiquing my old cataract surgery video
I was digging through some old computer files and I came across an old video that I made in 2006. … 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
Soft cataracts can be quite difficult
Most surgeons associate dense cataracts with increasing difficulty during cataract surgery because they require more ultrasonic energy to break up … More
the hemi-nucleus tuck technique
One of the challenges in phaco surgery is that we need to break up the nucleus in order to remove … More
Removing OVD from behind the IOL
Surgeons in training often ask, “Do I need to remove the viscoelastic from behind the IOL at the end of … More
Complete Cataract Case: a very special case
This is a complete cataract case, shown from the making of the first incision to the sealing of the incision. … More
The Subtleties of Cataract Surgery
The difference between good cataract surgery and great cataract surgery comes down to subtleties. There are very slight nuances to … More
Complete Case: Cortical Cataract
With a cortical cataract, patients are very symptomatic, particularly if the cortical opacities are within the visual axis. These tend … More
Review: Optimizing Cycle Time Efficiency
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety. … More
Show me a beautiful cataract surgery
Here on CataractCoach.com we have hundreds of teaching videos, and many of them are of very complex or complicated cases … 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
IOL delivery technique
While it seems relatively easy to insert the IOL with an injector system, there are subtleties in the technique which … More
Complete Case: Soft Cortical Cataract
Another addition to our series on Complete Cataract Cases is this technique for soft cortical cataracts. These cataracts are typically … 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
Complete Case: Cataract in a Small Eye
Looking at this picture, we can see that the corneal diameter is very small compared to the size of the … More
The Chopper Push Technique
Watch this video carefully and you will see that the chopper instrument is used just once to create a single … More
Complete Case: Chop in the Bag
Again we have a complete case, from start to finish, showing a routine cataract surgery with a phaco chop technique. … More
Review: Optimizing Cycle Time Efficiency
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety. … More
How much force for hydro-dissection?
When we perform hydro-dissection, how much force is needed? What volume of balanced salt solution is required? What are the … More
Refining your Surgical Signature
It is so important for surgeons to take pride in their work. You must do a great job, or don’t … More
Setting Up for Cataract Surgery
Cataract surgery is team work and the surgeon is just one member of the team. We need a great team … More
Epi-Nucleus Flip Technique
With a thick epi-nuclear shell, it is easier to remove it with the phaco probe as compared to the I/A … More
Review: External View of Cataract Surgery Steps
Two of the most critical steps in cataract surgery are the main phaco incision and the capsulorhexis. Properly completing these … More
Review: Side View of Hand Position
While we do hold the phaco probe with a pencil grip, we do not use the same angle as writing with … More
Checking the IOP at the end of surgery
We want to ensure an appropriate intra-ocular pressure (IOP) at the end of surgery. This puts the eye in a … More
Struggling with Phaco Chop? Let me help you
I will be the first to tell you that mastering phaco chop is not easy, but it is certainly worth … More
The trick to bring cataract pieces to the phaco tip
This is one of my favorite tricks to teach residents: when there is a nuclear piece of cataract in the … More
It takes new surgeons years to figure this out
This is such a great lesson, that I’m going to limit the text here. Watch the video and learn something … More
Tear Out of the Anterior Capsule
In this video, which was anonymously submitted, an experienced surgeon encounters a routine cataract case where the anterior capsule is … More
Cataract Surgery Lessons from Kyoto
I recently went to Kyoto, Japan for ophthalmology business development projects and I also had a chance to visit a … More
Draping the Eye for Cataract Surgery
Draping the eye is important for cataract surgery. It helps us to create a sterile field and it isolates the … 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
Review: Achieving the State of “Flow”
The psychological state of Flow is described as “energized focus, full involvement, and enjoyment” of the action being performed. Some call this … 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
Expert Level Divide-and-Conquer
Many surgeons like the divide-and-conquer technique and it is widely used here in the USA. For young surgeons, it is … 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
Guest Surgeon: Phaco Chop Technique
This video was anonymously submitted by an experienced surgeon who wants us to analyze the phaco chop technique and give … 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
Review: Angle sweep to remove all OVD
When we fill the eye with viscoelastic, we push it with the greatest force into the opposite angle of the … 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
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
Analysis of a Divide-and-Conquer Cataract Case
This anonymously submitted video is from a surgeon who is 5 years into practice after the culmination of her training. … More
Review: Embed the phaco probe without ultrasound
The classic teaching for phaco chop and quadrant removal is to embed the phaco probe into the nuclear piece by … More
What is the correct way to hold a fluid syringe?
When we have a syringe that is filled with liquid, be it balanced salt solution or visco-elastic, we have a … More
Does Capsule Polishing prevent capsular opacity?
There has been much debate around the issue of polishing of the undersurface of the anterior capsular rim, yet there … More
Guest Surgeon Efficient Divide-and-Conquer
After thousands of cases, surgeons become very efficient and can complete cataract procedures with fewer instruments and less surgical trauma. … More
Resident surgeons must learn to load the IOL
The surgeon must know how to do every single part of the surgery, including setting up the phaco machine and … More
Review: Cataract Surgery in Patients age 90+
Average life expectancy is at an all-time high in the US at 79, with even better news for people who … More
Quiz: For a pupil like this, what is your approach?
With time, young ophthalmologists develop surgical judgment and they are able to look at a case and decide what approach … More
Cataract Surgery using a Scleral Tunnel Incision
Twenty years ago, when I did my residency training at the Jules Stein Eye Institute at the UCLA School of … 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
Phaco Flip & Chop is great for Beverly Hills Cataracts
Often, the density of the nucleus and the severity of the cataract relates to the patient’s access to healthcare. In … More
What am I thinking while doing cataract surgery?
It’s time for a fun video — what am I thinking while performing cataract surgery? I like the operating room … More
Optimizing the Red Reflex during Surgery
Illumination through the ophthalmic microscope is important for visualization during cataract surgery. We use a combination of both coaxial and … 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
Sub-Tenon’s Anesthetic Injection Technique
Placing anesthetic agents in the retro-bulbar space provides excellent anesthesia and akinesia during ocular surgery. We have previously shown the … More
Review: How to load and inject a single-piece IOL
Let’s review a routine case, this time with a toric IOL. All surgeons in training must know how to properly … More
What’s on my Cataract Surgery Instrument tray?
In this video I take you through my instrument tray for routine cataract surgery. As you can see in this … More
Review: Divide and Conquer Phaco Technique
Every July, we mark the beginning of the academic year in the USA and this is when our residents progress … More
Tilt and Tumble Phaco Technique
The Tilt and Tumble phaco technique is a very efficient and safe method of nucleus removal. First described many years … More
Foot Pedal Positions for Learning Phaco Chop
Cataract surgery requires both hands and both feet of the surgeon in order to perform the modern techniques. It seems … More
External View of Critical Cataract Surgery Steps
Two of the most critical steps in cataract surgery are the main phaco incision and the capsulorhexis. Properly completing these … More
Superior Incision: Hand Position & Microscope Views
While I prefer the temporal approach for routine cataract surgeries, some surgeons prefer a superior incision. Many beginning surgeons who … More
Simultaneous Hand Position and Microscope View
For young ophthalmologists, learning how to hold the instruments and position the hands during cataract surgery can be difficult to … More
Proper Hand Positioning in Cataract Surgery
This is a special video because the camera is focused on my hands for the entire surgery, from placing the … More
Technique for Retrobulbar Anesthetic Injection
To perform a safe cataract surgery and to keep the patient comfortable and pain-free, we need to give a sufficient … More
Analysis of a Resident’s 60th Cataract Surgery
As we get close to starting the academic year in the USA (which runs from July 1, 2019 to June … More
Hand Positioning during Cataract Surgery
When performing micro-surgery, particularly intra-ocular surgery like cataract surgery, a high level of precision is required. The surgeon’s hand positioning … More
Analysis of a Resident’s 50th Cataract Surgery (Part 2)
Continuing from the previous post, this is part 2 of 2 of the analysis of a resident’s 50th cataract surgery. … More
Analysis of a Resident’s 50th Cataract Surgery (Part 1)
This is Part 1 of 2 where we are analyzing an anonymous resident’s 50th cataract surgery, which is very early … More
Learning to be consistent: 12 consecutive incisions
We aim to be consistent in our surgeries so that we can make a well-constructed incision each and every time. … More
Basics: How to Load and Inject a Three-Piece IOL
In the USA, the most commonly used IOL in routine cataract surgery is a single-piece acrylic IOL. These IOLs work … More
Review: Fully Separate Nucleus after the Phaco Chop
When doing phaco chop, remember that you must still physically push apart the nuclear halves to achieve complete separation and … More
Guest Surgeon teaches us Cataract Surgery Efficiency
We can always learn from fellow surgeons, particularly from those who are truly experts in the field. I recently met … More
What is your ideal Cataract Surgery case? Why?
What is your ideal cataract surgery case? Not your fastest case. Speed does not matter. Efficiency does, but that’s a … More
How to Flip Up the Epi-Nucleus for easy removal
Hydro-delineation can be helpful to separate the dense endo-nucleus from the epi-nucleus of the cataract. This makes is a bit … More
Sometimes Even Experts Struggle during Surgery
As we gain more experience and hone our surgical skills, we achieve the state of flow where the procedure progresses … More
If your Phaco Chop fails, simply revert to Stop-and-Chop
Sometimes we attempt to use phaco chop to divide the cataract nucleus, but we are just not able to achieve … More
Position the head so the iris is parallel to the floor
Proper positioning of the patient for cataract surgery is important for the comfort of the patient and the surgeon, but … More
The incision and capsulorhexis are your signature
I like to think of the phaco incision and the capsulorhexis as my “signature” on every cataract surgery that I … More
For loose zonules, bring the nucleus up and out
In this seemingly routine case, we find that the anterior lens capsule wrinkles when we attempt the capsulorhexis. This means … More
Technique for PSC Cataract Surgery in younger patients
Posterior SubCapsular (PSC) cataracts are more commonly found in our younger patients and in particular, they can cause difficulty with … More
Optimizing Surgical Flow for Efficiency & Safety
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety. … More
Flip and Chop Phaco is Ideal for Routine Cases
The flip and chop phaco technique has been presented here before on many occasions because it is such an efficient … More
Various Approaches to removing the Epi-Nucleus
When we perform hydro-delineation, we separate the dense endo-nucleus from the relatively soft epi-nucleus. This is helpful in multiple different … More
What is the secret to patient fixation during surgery?
Many ophthalmologists have asked me how my patients are able to maintain fixation during cataract surgery under topical anesthesia. In … More
Why is this patient yelling at me and the staff?
This is a routine cataract surgery that goes well and without complications. What is unusual about this case is the … More
Should we do bilateral same-day cataract surgery?
On rare occasions, I will do immediate, bilateral sequential cataract surgery so that a patient can have both right eye … More
How important is Capsule Polishing in Cataract Surgery?
In modern day cataract surgery, we remove the lens material which keeping the capsular bag to hold the IOL. How … More
The Angle Sweep Technique to Remove Viscoelastic
When we fill the eye with viscoelastic, we push it with the greatest force into the opposite angle of the … More
Surgical Exposure is Critical in Cataract Surgery
Head positioning and exposure of the surgical field is important for success in phacoemulsification. The patient should be supine with … More
Wound-Assist Technique for IOL Delivery
The switch from large-incision manual extracap cataract surgery to smaller-incision phacoemulsification was helped tremendously by the advent of foldable IOLs. … More
Phaco Incision Size: is smaller always better?
When it comes to incisions in the eye, it would seem that smaller is better. But is that always the … More
Routine Dense White Cataract Surgery
Finishing up our week of routine cataract cases, today we are reviewing dense white cataracts. In some parts of the … More
Routine Phaco Chop Cataract Surgery
Continuing with our series about routine cataract cases, today we present a routine phaco chop surgery. The cataract is chopped … More
Routine Flip-and-Chop Cataract Surgery
We have previously featured an instructional video for the Flip-and-Chop method of cataract surgery and there was a very strong … More
Routine Toric Case with Surgeon-Loaded IOL
Again, time to learn from a routine case — this is the type of case that is your “bread … More
Why I love Routine Cataract Cases
Many of the articles and videos here at CataractCoach.com feature unusual, difficult, or challenging cataract cases. These are fun videos … More
How to remove stubborn sub-incisional cortex
During cataract surgery it is important that we remove all of the lens cortex in order to minimize post-operative inflammation … More