The difference between good cataract surgery and great cataract surgery comes down to subtleties. There are very slight nuances to … More
Category: surgical pearls
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
Enlarge the Capsulorhexis
A small capsulorhexis makes nucleus removal more difficult, especially when we have a dense cataract. When the entire lens hardens … More
Staying calm when you see danger signs
The second that I see this round hole, I know that it is a danger sign. We have previously explained … More
Fixate the eye with your other hand
The problem with using two hands to hold the capsulorhexis forceps is that you lose the ability to have the … More
Examine instruments before using them
We must examine our instruments before using them to ensure that they are intact and in normal, working condition. In … More
DMEK surgery with pre-loaded graft
We have previously featured Descemet Membrane Endothelial Keratoplasty here on CataractCoach with a video from one of my residents and … More
Seems like a good chop but…
Another video for our series of Complete Cataract Cases, we present a surgery of me operating. During this surgery, I … More
Predicting Pseudo-Exfoliation weakeness
We have previously covered the topic of pseudo-exfoliation (PXF) in detail here on CataractCoach. It is an important topic because … More
IOL cartridges – which one?
There are many different IOL injector systems from multiple different IOL manufacturers. It is the surgeon’s job to know the … More
Ensuring accuracy of A-scan ultrasound
Correlate A-scan & biometry measurements to improve accuracy in IOL calculations. This case shows how disparate measurements can lead to … 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
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
What are these lines? What is Reflux?
These lines are the posterior capsule which has found its way into the suction port of the I/A probe. We … More
Fix this Iris Prolapse in 2 seconds
Really. This is not an exaggeration. If you understand the physics of why the iris is prolapsing through the incision, … More
Cortical Cataracts can cause “white-out”
Cortical cataracts occur when some of the lens material becomes liquefied, thereby blocking the visual axis. When we perform hydro-dissection … More
Phaco Chop in patients over age 90
In previous videos we have explained the differences when operating on nonagenarian patients. These patients have weaker tissues such as … 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
The Smallest Permissible Capsulorhexis
From watching our videos, you know that for most cases, I find that a 5 mm capsulorhexis is ideal. This … 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
Complete Case: Dense PSC & Shallow AC
This is a complete case, shown from start to finish. For many of our CataractCoach viewers, particularly the surgeons 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
Three-piece IOL: B versus C cartridge
There are two options for injecting an Alcon three-piece IOL using the Monarch injector: the B cartridge is bigger and … More
Cataract Quiz: Why is this cortex so adherent?
This seemed like a completely normal case… until it came time for removal of the last bit of cortex, which … 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
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
Quick Fix for Reverse Pupillary Block
In myopic eyes and post-vitrectomy eyes, we can get an overly deep anterior chamber during cataract surgery. The infusion pressure … More
What can we learn from the first eye cataract surgery?
The patient had cataract surgery of the right eye two years ago. Initially, she had a plano outcome and great … More
Review: Surgical Peripheral Iridotomy
There are times when you will need to make a surgical iridotomy either during cataract surgery or as a stand-alone … More
Re-draping the eye makes surgery more efficient
When we place the drapes on the eye and eyelids, it serves to give us better exposure of the surgical … 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
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
Capsulorhexis with an anterior capsular plaque
This anterior capsular plaque makes the capsulorhexis creation more challenging. The capsule will not tear predictably in the region of … More
Cataract Surgery in a 100-year-old patient
We should all be so lucky to live to 100 years old. It’s quite a rarity and it is something … 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
Learning Surgical Pearls from Colleagues
There are all sorts of surgical pearls that we can learn from our colleagues. Different techniques and methods of making … More