This is a seemingly routine case, shown start to finish, where I find it challenging to rotate the nucleus despite … More
Category: surgical pearls
1439: save this case of capsule rupture
Our guest ophthalmologist is Dr Cathy McCabe from Florida, USA and she is truly a master surgeon, having done tens … More
1438: intra-lenticular foreign body
Our guest surgeon is Asst. Prof. Christina Mamalis MD from the University of Texas in Houston, and she presents a … More
1432: high myopia refractive targeting
There is a reason why I recommend that you do NOT aim for a plano outcome in highly myopic eyes. … More
1431: this is why I just need one chop
For routine cataract cases, I can perform just one phaco chop to split the nucleus into two halves and then … More
1429: refractive lens exchange pearls
In my quest to give away every secret, surgical pearl, and useful bit of knowledge that I have acquired over … More
1419: How to reposition a toric IOL
It is now months after the original cataract surgery and you examine your patient and realize that the toric IOL … More
1411: how much capsule polishing to do?
Capsule polishing to remove tiny residual bits of lens material is frequently done in cataract surgery. We have asked our … More
1403: tips & tricks for using iris hooks
Iris hooks are very useful for expanding the pupil during cataract surgery. The iris hooks have an advantage over pupil … More
1400: handling the run-out capsulorhexis
The capsulorhexis has a tendency to run-out if the anterior lens capsule is insufficiently flattened, if there is any posterior … More
1384: four short videos with great pearls
Today we present four short videos with great surgical pearls. I am sure that you will learn something new and … More
1372: my best pearl for Flomax/IFIS cases
This is a complete cataract case shown start to finish in a patient who has floppy iris syndrome due to … More
1358: sub-incisional cortex removal
In the USA, the most common method for removal of cortex is using a coaxial IA probe, whereas in other … More
1356: effective draping for cataract surgery
Watching amazing intra-ocular acrobatics during a challenging cataract case is exciting and makes for a great video, but those cases … More
1353: this means no pupil ring needed
There are some cases where you absolutely need a pupil expansion ring or iris hooks, such as this case. That … More
1349: share your best surgical pearl
We had some much needed rain in Los Angeles recently and I was fortunate to catch a beautiful rainbow. And … More
1341: phaco in a trabeculectomy eye
Anytime we perform cataract surgery in an eye with prior ocular surgery, there are additional challenges. In eyes with prior … More
1340: plan your rhexis to avoid opacities
Yesterday’s video (#1339) showed how to move cortical opacities from the path of the capsulorhexis by pushing the liquefied lens … More
1339: you can move cortical spokes
Cortical lens opacities tend to block the red reflex which can make capsulorhexis creation more difficult. Since these cortical spokes … More
1337: how to needle encapsulated setons
A glaucoma seton, such as the Ahmed Valve from New World Medical (by the way, it is not named or … More
1330: resolving intra-op chemosis
Conjunctival chemosis can happen during cataract surgery if one of our incisions nicks the edge of the conjunctiva. This allows … More
1325: Lens Iris Diaphragm Retropulsion
LIDRS is lens iris diaphragm retropulsion syndrome and it occurs when the iris forms a seal around the anterior capsule … More
1288: the subtleties of efficient surgery
Becoming efficient in the operating room is not easy and it takes years to truly hone your craft. Remember that … More
1285: remove the central capsule wrinkle
In very myopic eyes, the capsular bag is actually bigger, the same way that the corneal white to white diameter … More
1277: more learning from audio clues
In this video a different surgeon is using a different phaco machine and a different technique to perform cataract surgery. … More
1276: audio clues from phaco machine
Your phaco machines makes all sorts of musical sounds when you are operating in order to give you real-time feedback … More
1252: how I handle soft cataracts
Soft cataracts require one important step for success: get the nucleus away from the posterior capsule. I like to accomplish … More
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
1099: some amazing surgical pearls
With CataractCoach, I am sharing everything that I have learned or figured out during the past 25 years in ophthalmology. … More
1095: Where to place the chopper
Let’s admit that phaco chop can be a tough technique to learn. It requires both hands to perform a different … More
1089: Try the CataractCoach Challenge
Take the CataractCoach challenge: perform a cataract surgery while keeping the light reflex (Purkinje image) in the central zone of … More
1080: phaco tip punctures the capsule
This anonymously submitted video shows a complication that can happen to any of us. This patient had a white cataract … More