Nanophthalmic eyes are very small with a short axial length of less than 20 mm. This makes the cataract surgery … More
Category: shallow AC
1908: nanophthalmos & decompression
This patient has true nanophthalmos with an axial length of less than 20mm and a calculated IOL power of 67 … More
1900: iris bombata / iris bombé
Iris bombata (or iris bombé) is a condition where posterior synechiae at the pupil margin have completely sealed the posterior … More
1862: nanophthalmic eye cataract surgery
Experienced cataract surgeons know that the most challenging cataract cases are often the nanophthalmic eyes. These tiny eyes have a … More
1748: tiny hyperopic eye & small pupil
Just watching this case is stressful. It is a very small eye with a 20 mm axial length, shallow anterior … More
1731: small eye, shallow AC, high hyperopia
As surgeons, we love it when we can make an incredible improvement in the lives of our patients. An added … More
1717: bilateral phacomorphic glaucoma
This is a very unusual case of bilateral phacomorphic glaucoma where the swollen cataract caused the narrow angles to occlude. … More
1713: pars plana tap for aqueous misdirection
The key to resolving iris prolapse is to release the pressure gradient and we have covered this topic many times … More
1695: why I am doing stop and chop?
If phaco chop is so amazing, then why am I doing stop and chop in this case? Answer is in … More
1656: a really tough case for a resident
For any cataract surgeon this is a tough case: 94 year old patient (nonagenarian), short axial length, shallow anterior chamber, … More
1625: aqueous fluid misdirection syndrome
This is my video from the Cataract Spotlight session by Dr David Chang from the American Academy of Ophthalmology 2022 … More
1618: Why did I choose stop-and-chop?
For 22 years, I did a combination of both private practice as well as academics in which I taught the … More
1610: poly-pseudophakia 2 IOLs in 1 eye
Nanophthalmic eyes are among the most challenging when it comes to cataract surgery. There are additional risks and the working … More
1572: solving iris prolapse in a small eye
Our guest today is Dr Mohamed Sayed (formerly in Miami, now in Dubai), a master surgeon who has taught us … More
1549: cataract surgery in angle closure
Cataract surgery in the setting of angle closure glaucoma is very challenging because the anterior chamber is very shallow, the … More
1542: tough resident cataract case
This is a very tough resident cataract case and there are some complications. The most important point is that the … More
1514: “the toughest case of my life”
“The toughest case of my life” is quite a statement when it is said by a highly experienced, expert level … More
1407: challenging uveitic cataract
This patient is monocular and has an opaque cataract that developed in the setting of chronic uveitis. This has cause … More
1388: small eye, small pupil, dense cataract
This is a very tough case: a small eye with a shallow anterior chamber, a small pupil with iris laxity, … More
1327: nanophthalmic eye with flat AC
Our guest surgeons today teamed up to help complete this cataract surgery in a nanophthalmic eye. The axial length is … More
1299: cataract surgery in nanophthalmos
This patient has a very small eye with an axial length of just 15 mm. That makes the entire surgery … More
Severe Zonular Laxity in PXF Cataracts
This is a really difficult surgery and we know that ahead of time. When we examine this patient at the … 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
Finishing this case will be difficult
The reason why ophthalmologists need to perform at least 1,000 cataract surgeries until they are sufficiently up the learning curve, … More
tiny pupil and fibrotic membrane
This is a very tough case for this senior resident. The patient has a history of chronic uveitis, which has … More
Review: if the bag shallows during cortex removal
The irrigation / aspiration probe is placed in the eye and we begin cortex removal. But as we try to … More
Review: Surgical Peripheral Iridotomy
here are times when you will need to make a surgical iridotomy either during cataract surgery or as a stand-alone … 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
Review: Small Eye with high power IOL
Cataract surgery can provide an incredible refractive result, particularly for small eyes which are highly hyperopic. We can correct 10 … 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
Review: Pseudo-Exfoliation Cataract Surgery
Pseudo-Exfoliation / Small Pupil / Weak Zonules / Shallow AC (watch video below) A sweet 80 year old patient comes … 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
Toric IOL planning in a small eye (+29.5 D)
Our main phaco incision will induce astigmatism and multiple variables affect the degree of this change. Larger incisions have more … 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
Cataract Surgery with Synechaie Lysis
Synechiae are adhesions of the iris to ocular structures which can cause issues of aqueous blockage, pupil dilation, and more. … More
Cataract surgery in Nanophthalmos
Nanophthalmic eyes are very small with a short axial length of less than 20 mm. This makes the cataract surgery … More
Cataract Surgery with High Power IOL placement
Cataract surgery can provide an incredible refractive result, particularly for small eyes which are highly hyperopic. We can correct 10 … More
Quiz: A shallowing capsular bag during cortex removal
The irrigation / aspiration probe is placed in the eye and we begin cortex removal. But as we try to … More
Surgical Peripheral Iridotomy using 23g Vitrector
There are times when you will need to make a surgical iridotomy either during cataract surgery or as a stand-alone … More
Guest Surgeon: Cataract with prior Trabeculectomy
This is a great video submitted by Dr. Mohammed Ghoneem from Alexandria, Egypt where he shows his method for successful … More
Inject more OVD before manipulating the IOL
When we insert the IOL, sometimes viscoelastic will be lost via the main incision. This can happen if we gape … More
Avoid Posterior Pressure from the Speculum
We need to place a lid speculum to get the best exposure for cataract surgery, but if we crank it … More
Flatten the Anterior Lens Capsule with Viscoelastic
Using a Viscoelastic (also called Ophthalmic Visco-surgical Device, or OVD) to flatten the anterior lens capsule is a critical step … More
Soft-Shell Technique for Viscoelastics
The Soft-Shell Technique for viscoelastic use in cataract surgery was developed by Dr. Steve Arshinoff as a method of getting … More
Cataract Surgery with a very shallow Anterior Chamber
This small eye suffered from angle closure and subsequent development of a white cataract. The angle closure was successfully treated … More