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

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

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

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

Cataract Surgery in Pseudo-Exfoliation Syndrome

We often encounter patients with Pseudo-Exfoliation Syndrome, often abbreviated as PXF, which makes cataract surgery significantly more challenging. The PXF … More

Cataract surgery after prior trabeculectomy

A well-functioning trabeculectomy surgery is a delicate balance between the aqueous production and the additional outflow via the filtering bleb. … More

Review: Phaco Incision paired with LRI for Astigmatism Correction

We know that the phaco incision will cause some degree of corneal flattening and this has the ability to alter … More

The ideal Angle of Approach for the phaco incision

The angle of approach of the keratome will determine the tunnel length of our phaco incision. If the angle is … More

What IOL Power do you choose for this patient?

This 60 year old patient is seeing you in consultation for cataract surgery. He has a significant posterior subcapsular cataract … More

Position the head so the iris is parallel to the floor

Proper positioning of the patient for cataract surgery is important for the comfort of the patient and the surgeon, but … More

Optimizing Surgical Flow for Efficiency & Safety

Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety. … More

Quiz: Should you implant a Toric IOL in this eye?

The patient is 70 years old and the corneal scar of the left eye is about 80% depth within the … More

Match the Phaco Incision to the Limbal Relaxing Incision

We know that the phaco incision will cause some degree of corneal flattening and this has the ability to alter … More

Complete Toric IOL Case: from Marking to Alignment

Toric IOLs allow us to surgically treat corneal astigmatism at the time of cataract surgery thereby providing our patients with … More

Please do NOT use the iris to guide Capulorhexis size!

Many surgeons use the iris or pupil size as a guide for capsulorhexis creation — but you should not. Do … More

Surgical Exposure is Critical in Cataract Surgery

Head positioning and exposure of the surgical field is important for success in phacoemulsification. The patient should be supine with … More

IOL Calculations in Ultra High Myopia

Most people consider high myopia to be about -10 diopters or greater. We have covered this topic extensively in the … More

Phaco Incision Size: is smaller always better?

When it comes to incisions in the eye, it would seem that smaller is better. But is that always the … More

The Patient Refuses Refractive Correction!

This 75 year old patient needs cataract surgery because her best corrected vision is 20/50 and it is becoming increasingly … More

Some Simple Ophthalmology Mathematics

Ophthalmology has a large degree of math, particularly when it comes to refractive surgery. Our most commonly performed and most … More

Surgically Treating Residual Astigmatism

Which do you choose: Limbal Relaxing Incision (LRI) or Laser Vision Correction (LVC) for treatment of residual astigmatism after cataract … More

Basics of Limbal Relaxing Incisions (LRIs)

Every incision that is made in the cornea has an effect on its shape and therefore the astigmatism. For a … More

Cataract Surgery Technique in Highly Myopic Eyes

We have previously featured an article about doing cataract surgery in these highly myopic eyes, so we will focus on the surgical … More

Choosing Refractive Targets to maximize Depth of Field

From this photo it is obvious that the aperture size of a camera makes a large difference in the depth … More

3 Golden Rules for Patient Discussions

Physicians need to understand importance of patient discussions regarding surgery Letting patients speak, making a specific recommendation, and explaining what … More

Step-by-Step Technique for Toric IOLs

Toric IOLs can provide the added benefit of addressing astigmatism at the time of cataract surgery. They are available in … More

Alignment and Centration of Toric Multi-Focal IOLs

[From CataractCoach.com] New technology has given us the ability to address corneal astigmatism and presbyopia with a toric multi-focal IOL. … More

Nevus of Ota Cataract Surgery

Nevus of Ota refers to hyperpigmented lesions on the sclera as well as peri-ocular skin. The color tends to … More

I teach all young surgeons these 3 Tenets for Success

It’s hard to boil down decades of a career into three easy tenets, but the key principles needed for surgical … More

The Informed Consent Process for Cataract Surgery

As ophthalmologists, we know the most about cataracts and the potential benefit to our patients of any planned cataract … More