This patient has a long standing uveitis which is currently under control as well as uveitic glaucoma which required placement … More
Category: small pupil
Small pupil, PXF, and IFIS
For a beginning surgeon it is helpful to see surgeons performing techniques that are out of your comfort zone. The … More
Pearls for small pupil cataract surgery
There are some great surgical pearls for dealing with small pupils during cataract surgery and this video explains some of … More
Quiz: Should I have used a pupil ring?
This is a tough case and the pupil is smaller than I expected. Should I have used a pupil expansion … 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
Complete Case: Floppy Iris & Loose Zonules
There is a benefit to watching a video of a complete cataract case, from start to finish. This is particularly … More
Toric IOL technique with a small pupil
The toric IOL is a great option to address astigmatism at the time of cataract surgery. For the toric IOL … More
Step-by-step: Malyugin Pupil Ring
To perform cataract surgery in an eye with a small pupil, it helps to expand the pupil to a more … 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
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
Always check under the Iris
We have covered this lesson before, but it certainly is worth repeating: always check under the iris when you perform … More
Review: Check under the iris for lens material
When performing cataract surgery for an eye with a moderate or small pupil, be sure to check under the iris … More
Lysis of Synechiae and Cataract Surgery
In patients with prior uveitis, synechiae between the iris and the anterior lens capsule can develop. These adhesions will prevent … More
Phaco Chop in the bag with smaller pupils
In many of the prior videos related to smaller pupils, I have emphasized the technique of bringing the nucleus partially … More
Learn the Pupil Stretch Technique
Stretching the pupil during cataract surgery is a safe and effective way to improve access via mechanical dilation. While there … 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
Synechiae & Small Pupil solved with the B-Hex ring
This video features guest surgeon Neto Rosatelli MD from Brazil showing us his approach to cataract surgery in a uveitic … More
Checking under the Iris for Hidden Cortex
In cases where the pupil does not dilate fully, it can be difficult to see the entire capsular bag to … More
Higher Infusion Pressure Helps in Floppy Iris Cases
In our phaco fundamentals series, we have explained the basics of choosing fluidic parameters for the phaco machines. These settings … More
Malyugin Ring for Pupil Expansion in Cataract Surgery
A well-dilated pupil facilitates cataract surgery and if the patient has a small pupil there are multiple options for safely … 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
Guest Cataract Surgery: Tiny Pupil with Synechiae
This patient had a prior uveitic episode which resulted in the formation of posterior synechiae, where the iris, at the … More
The iris/pupil can hold the nucleus during phaco
Today we have an unedited video of a routine case in a patient with floppy iris syndrome due to Flomax … More
Ovoid Pupils in Cataract Surgery – What Happened?
What is happening in these cataract surgery patients with prior Flomax (tamsulosin) use? Why are the pupils ovoid in shape? … More
Pearls for Using Iris Hooks to Expand Small Pupils
Sometimes, the best approach to expanding a small pupil for cataract surgery is to use iris hooks. These are small, … More
Twist Technique to Easily Explant the IOL
There are times when we need to explant an IOL from the eye. This can be at the time of … 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
Expert Technique: Small Pupil & Dense Cataract
Very experienced surgeons never rest — they are always looking to learn more. Like you, I learn a lot from … More
Pupil Ring placed in one movement, but there is a catch…
I wanted to try a new technique: placing all 4 scrolls of the Malyugin ring on the iris in one … More
Small Pupil Flomax Adventures (without a ring!)
This is a really fun cataract surgery. After tens of thousands of cases, an unusual or challenging clinical situation really makes … More
Pupil Stretch using Capsulorhexis Forceps
To stretch a small pupil, you actually don’t need special instruments. Using two instruments such as choppers, hooks, or manipulators, … More
Tips & Tricks for Using Pupil Expansion Devices
While I don’t use them often, pupil expansion devices such as the Malyugin ring, are useful when performing cataract surgery … More
Check under the Iris for Hidden Cortex Material
When performing cataract surgery for an eye with a moderate or small pupil, be sure to check under the iris … More
Floppy Iris Syndrome with Phaco Chop
We have a fun case here: the patient has a long-time history of Flomax (tamsulosin) use which limits his pupil … More
Lifting the nucleus up though a small pupil
Here at CataractCoach, we have featured videos showing how to hydro-dissect a nucleus up, out of the capsular bag and … More
Expansion Ring for Small Pupil Cataract Surgery
For small pupil cases, I prefer to do stretching in order to expand the pupil and then I can proceed … More
Rescuing the Radialized Capsulorhexis
The capsulorhexis is an important early step of cataract surgery because it gives strength to the capsular opening so that … More
Phaco Chop with Floppy Iris Syndrome
Many of our male patients take medications to help with urinary flow such as alpha-1 antagonists, the most common of … 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
Complex Cataract: multiple challenging issues
This patient had a large rhegmatogenous retinal detachment repaired a few years ago with a successful pars plana vitrectomy. The … More
Bleeding from Pupil Expander! Now What?
Pupil expansion devices can be helpful to provide sufficient dilation in cataract surgery. This video features guest surgeon Ravi D. Goel, … More
3 tricks for Small Pupil + Flomax Cataract Surgery without Expanders or Iris Hooks
Can you do cataract surgery in an eye with a small pupil without having to use expanders or iris … More
Cataract Surgery with Pupil Stretching
No need for pupil expansion rings or iris hooks for many cases (full video below) Yesterday’s video about dealing with … More
Pseudo-Exfoliation Cataract Surgery
Pseudo-Exfoliation / Small Pupil / Weak Zonules / Shallow AC (watch video below) A sweet 80 year old patient comes … More
Posterior Polar Cataract: Expert Level with Small Pupil, Floppy Iris, Dense Lens
Yesterday’s video showed the technique of using Visco-Dissection to aid in surgery for posterior polar cataracts. That patient had a … More
Cataract Surgery with a Mid-Size Pupil without using iris hooks or expansion devices
How do we do cataract surgery in an eye with a mid-sized pupil of about 3 or 4 mm in … More