This young patient presents with dense posterior subcapsular (PSC) cataracts in both eyes which is severely limiting the vision. The … More
Category: surgical planning
1643: limitations with the Vivity IOL
***I mis-spoke at the 1 min mark: small aperture is more depth of field and longer shutter time. The large … More
1594: healing & anatomy affect outcomes
Patient anatomy and healing greatly affect outcomes. The visual results of surgery depend both on surgeon as well as patient … More
1593: this EDOF patient will be amazed
What are the factors for success with EDOF (extended depth of focus) IOLs? How can we ensure that the patient … More
1481: ASCRS case 12: phaco in trab eyes
This is our last of the dozen cases presented at the CataractCoach instructional course at the 2022 ASCRS meeting. When … More
1479: ASCRS case 10: topo & tomography
How do you make a surgical plan to correct astigmatism when the keratometer, topographer, and tomographer show differing degrees and … 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
1357: biometry for trifocal IOLs
The new generation of diffractive trifocal IOLs such as the Alcon PanOptix and the J&J Tecnis Synergy are able to … More
1342: treat from the brain and heart
We have previously discussed the Golden Rule of patient care where we give every patient the same high level of … More
1318: trifocal IOL performance years later
In the USA we have had access to some trifocal IOLs for the last couple of years. During that time … More
1315: Update on the Tecnis Eyhance IOL
This video gives an update on my experience with the J&J Tecnis Eyhance monofocal IOL. It is a good monofocal … More
1272: the Golden Rule for patient care
I only remember a few things about kindergarten: playing handball during recess, watching Matilda eat paste, and learning the golden … More
1251: re-aligning a toric IOL without OVD
Our guest surgeon, Dr Alex Abdo Martins from Brazil, has a very interesting case for us. This patient has a … More
1227: secrets for radial keratotomy patients
While radial keratotomy (RK) is rarely used as a refractive surgery today, a few decades ago it was very popular. … 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
1174: picking the right IOL for each eye
We are fortunate to have a wide range of different IOLs to offer our patients. We have bifocal IOLs, trifocal … More
1127: keeping track of surgical timing
You are the master of your own domain. The master of your own career. The master of your own life. … 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
1104: Playlist: Post-Op Day 1
Modern day cataract surgery has a very high success and safety record, with the vast majority of patients having a … 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
1084: toric planning for high astigmatism
Our video today showcases the surgical planning for this patient with a high degree of corneal astigmatism. We will go … More
1075: Can I use EDOF with eye disease?
I am frequently asked if the new class of EDOF (extended depth of focus) IOLs can be used in eyes … More
1073: Why did the AC Depth increase?
This patient had biometry performed in our clinic, using the same machine in 2017 and then again in 2021. Of … More
1003: Why did the patient go elsewhere?
This video shows two complete surgeries, both presented at high speed. The original cataract surgery was performed by me and … More
clean your optics & focus the microscope
This is actually a very important lesson. Your microscope optics will determine your view for the surgery and that could … More
IOL design differences
We have many different IOL designs available for use in cataract surgery and even within the most popular category (single-piece, … More
choosing refractive targets
Plano is not always the goal It would seem logical that emmetropia is the ideal refractive state of the eye. … More
Cataract Surgery with prior Amblyopia
The most common causes of amblyopia are related to either strabismus or an untreated refractive error, particularly in one eye … More
Angle Alpha and Angle Kappa with IOLs
If an IOL has zero power, such as in an extremely myopic patient, where we place it in the eye … More
Review: Optimizing Cycle Time Efficiency
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety. … More
Review: The Angle of Approach for Incisions
The angle of approach of the keratome will determine the tunnel length of our phaco incision. If the angle is … More
Intra-scleral Gore-Tex IOL fixation
This young patient sustained severe ocular trauma a few years ago and he had a surgical repair done in another … 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
Leukocoria in a newborn baby
Leukocoria in a newborn baby is an urgent situation that needs immediate attention from an ophthalmologist. The cause of the … More
Mentally Recovering from Complications
There are only two types of ophthalmologists who never, ever get surgical complications: (1) those who don’t operate, and (2) … More
Cataract Surgery with Pterygium Present
For a patient with both a pterygium and a visually significant cataract, the best option is usually to do the … 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
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 Smallest Permissible Capsulorhexis
From watching our videos, you know that for most cases, I find that a 5 mm capsulorhexis is ideal. This … More
Choosing Toric IOL Steps
For toric IOLs, we need to select the best spherical power as well as the ideal toric step. What is … 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
How to do Limbal Relaxing Incisions
Just about any incision in the cornea will induce some astigmatic change. We have shown how to place the phaco … More
Quiz: what is different about this white cataract?
This patient has an intumescent white cataract but something is different about this case. In fact, there is a very … More
Cataract Surgery Draping is Critical
Watching amazing intra-ocular acrobatics during a challenging cataract case is exciting and makes for a great video, but those cases … More
Surgeon Ergonomics for Ocular Surgery
As an ophthalmic surgeon, you will spend a large part of your future in the operating room performing delicate ocular … More
Review: Cataract Surgery in Deep Set Eyes
Performing intra-ocular surgery in a deep set eye is challenging because the access is limited. In the case shown here, … More
Alcon PanOptix Trifocal IOL Performance
In the USA, the FDA has recently approved the Alcon PanOptix IOL for use in cataract surgery. This is a … More
Solving a tough case of Hexagonal Keratotomy
Featuring guest surgeon: Arun Gulani MD from Jacksonville, Florida, USA This complex case involved a patient who underwent hexagonal keratotomy … More
Does age make a difference in IOL surgical planning?
We have some amazing surgical technology now with IOLs that give a wide range of vision and can even help … More
Quiz: Which eye do you fix first?
This patient needs surgery on both eyes. The right eye has a cataract which is limiting the vision to 20/80 … More