Soft cataracts require one important step for success: get the nucleus away from the posterior capsule. I like to accomplish … More
Category: surgical pearls
1208: center IOLs with Purkinje images
For monofocal IOLs, a small amount of IOL decentration will have a minimal effect, particular in IOLs with low or … More
1207: soft PSC cataract technique
This a complete cataract case, shown start to finish, for a young patient (age is early 30s) who has an … More
1205: how to perfect your capsulorhexis
The capsulorhexis is crucial in cataract surgery because it gives capsular integrity during nucleus and cortex removal and also provides … More
1204: IOL exchange with stuck haptic
This patient has very high demands for his vision and to address the issue of presbyopia in his mid 50s … More
1199: predicting a phaco wound burn
A phaco wound burn is a terrible complication that happens from the heat that is created by the friction of … More
1195: when you should not operate
Any surgeon can operate, but it takes a surgeon with good judgment to know when not to operate. During my training, one … More
1180: adjusting aspiration flow rate
The aspiration flow rate on a peristaltic phaco pump determines the speed at which balanced salt solution enters the anterior … More
1172: anterior capsular tear in phaco
The lens capsular bag is fragile and very thin, with an anterior measurement of about 14 microns and a posterior … More
1168: rescue this descemet’s detachment
Descemet’s membrane is very delicate and it can become detached during surgery. The usual entry site is from one of … More
1152: upside down IOL with bent haptic
You are performing cataract surgery on this patient and the case is going beautifully. You made a perfect 5 mm … More
1149: posterior capsulorhexis technique
There are times when it is helpful to perform a posterior capsulorhexis. This is a tricky maneuver because it opens … More
1137: too soft to chop, so tumble it
If you know a variety of different phaco techniques, it is easy to switch gears and shift to something that … More
1136: Refractive Lens Exchange Surgery
For high degrees of hyperopia in presbyopic patients, the best surgical solution is refractive lens exchange. For a younger patient, … More
1135: IOL cutting for IOL exchange
Our guest surgeon is Jeff Whitman MD from Dallas, Texas, USA who shows us his technique for IOL exchange. While … More
1131: Cataract Surgery in Ocular Albinism
Ocular albinism is rare, however just about every cataract surgeon will encounter at least one or two patients with this … More
1128: Why can’t I get the nuclear piece up?
You are ready for action. You embed the phaco probe and achieve high vacuum. You carefully place the chopper into … More
1124: Pearls for learning MSICS
It may surprise you to know that many young ophthalmologists in the USA do not have experience performing MSICS. In … More
1114: success with young cataract patients
When we are operating on a younger cataract patients, the stakes are higher and the surgery must last the patient … More
1112: surgical pearls for ocular asymmetry
While most patients have eyes that are very similar, there are a few patients where the eyes are remarkably different, … More