Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety. … More
Category: surgical planning
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
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
Comparison of Night Vision with Different IOLs
Patients often ask me if any of the new lens designs will give them youthful vision. The truth is that … 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