2772: nanophthalmic eye with astigmatism

This is a complete cataract case, shown start to finish, where I perform the entire surgery and present it to … More

2681: the capsule splits in posterior polar

In the two cases of posterior polar cataract shown here, the posterior capsule split occurs and the anterior hyaloid face … More

2668: high hyperope with high astigmatism

Cataract surgery in highly hyperopic eyes with short axial lengths and significant corneal astigmatism is technically demanding. The shallower anterior … More

2665: How to reposition a Toric IOL

Repositioning a toric intraocular lens (IOL) is indicated when postoperative rotation leads to suboptimal astigmatic correction, typically beyond 10 degrees … More

2468: the prior vitrectomy hit the capsule

This patient had 4 prior pars plana vitrectomies: the first was to treat a retinal detachment, then the patient re-detached … More

2465: approach to short axial lengths

I enjoy operating on very myopic eyes because there is so much room within the anterior segment of the eye. … More

2303: double toric IOLs in the bag

Our podcast yesterday (the top podcast in all of ophthalmology) featured Dr Robert Weinstock where he described an unusual case … More

2289: scleral suture fixation of a toric IOL

This patient had trauma which resulted in a ruptured globe as you can see from the large corneal laceration which … More

2259: toric Evo Visian ICL phakic implant

When I first started to use the Visian ICL phakic lens implant in 2006, it was a different time with … More

1972: toric guidance system gets confused

Remember that you should trust your surgical judgment more than any machine. In this case, the toric guidance system gets … More

1950: toric IOL with prior 16-cut RK

I have so many radial keratotomy patients who are seeking cataract surgery, usually at least a couple every week (and … More

1949: Toric IOLs in Fuchs’ Corneal Dystrophy

can you use a toric IOL in cataract surgery if the patient has Fuchs’ corneal dystrophy?

1820: monocular with pseudo-exfoliation

Ophthalmologists are very familiar with pseudo-exfoliation syndrome since it makes the cataract surgery more challenging due to poor dilation or … More

1716: astigmatism in radial keratotomy

For patients with prior radial keratotomy (RK), cataract surgery has to be done differently. These eyes also often have significant … More

1674: IOL choice in a teenager

This young patient presents with dense posterior subcapsular (PSC) cataracts in both eyes which is severely limiting the vision. The … More

1660: monocular patient with prior trab

A monocular patient is always a challenge because the patient has just the one eye. This often instills a fear … More

1650: how to reposition a toric IOL

When we implant a toric IOL to address pre-existing corneal astigmatism, we need to orient the axis of the IOL … More

1592: off-axis incisions and toric IOLs

Your surgically induced astigmatism (SIA) from your standard phaco incision is probably far less predictable than you think. There are … More

1564: on-axis incisions for toric IOLs

In most cases, I like to make the phaco incision on the steep meridian of corneal astigmatism. If the patient … More

1552: skill level after 250 cases done

Another anonymous USA resident sent me a video of the last case of residency, case number 250 where the nucleus … More

1512: stereoscopic 3D surgical videos

The first time I used a heads-up 3D viewing system for cataract surgery was more than 10 years ago. By … More

1501: complete toric IOL technique

Toric IOLs are great options to address corneal astigmatism, especially when it is 1 diopter or greater in magnitude. This … More

1449: monocular patient with 16 cut RK

This is a tough case in a patient with just one eye. He had a prior history of 16-cut radial … 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

1348: pupil stretch, toric IOL, steroid implant

Our guest surgeon Dr Himani Goyal does a masterful cataract surgery for this monocular patient. We are showing the entire … More

1317: Is a toric IOL ok in Fuchs’ Dys?

We can do cataract surgery for patients with Fuchs’ corneal dystrophy, but we must weigh the relative risks of corneal … More

1310: why the capsulorhexis matters

The capsulorhexis is a critical step of cataract surgery for two main reasons: it creates a stable and strong opening … More

1259: OSN NY differing astigmatism

This talk is one of my lectures from the OSN NY 2021 meeting. This is the Ocular Surgery News meeting … More

1258: OSN NY managing capsular issues

This talk is one of my lectures from the OSN NY 2021 meeting. This is the Ocular Surgery News meeting … 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

1249: time for the second eye of #1248

Yesterday’s video (1248) showed a very challenging case of compromised zonular support in a patient who may have had prior … More

1248: surgeon surprised by zonular loss

A careful slit-lamp microscope examination of the eye during the pre-operative consultation can pick up most cases of compromised zonular … 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

1219: posterior polar capsule rupture

This patient has bilateral posterior polar cataracts which progressively became more opaque and caused increasing visual problems. The first eye … More

1212: resident posterior polar cataract

Studies have shown that 1 out of 3 posterior polar cataract surgeries result in a ruptured posterior capsule. Here’s the … More

1200: small pupil toric IOL case

These are my pearls for implanting a toric IOL and achieving accurate alignment in small pupil cataract cases. These cases … More

1196: newbie guide for toric IOL success

Using a toric IOL is an important skill for an ophthalmology resident to learn. This video gives pearls for learning … 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

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

1100: Very soft PSC cataract technique

This patient is young, under age 40, and has been suffering from posterior subcapsular cataracts for more than 1 year. … 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

1050: complete case: Toric EDOF IOL

This patient is a young man, in his 40s, with a history of cataract development over the last few years. … More

1017: complete case with dense endo-nucleus

This complete cataract cases features a younger patient who developed bilateral cataracts with a dense endo-nucleus. We also implant a … More

999: Playlist: Toric IOLs

For the correction of astigmatism at the time of cataract surgery, toric IOLs can be an excellent option. The best … More

Ruptured Posterior Capsule Recovery

This patient had uneventful cataract surgery in the first eye with placement of a toric trifocal IOL in the capsular … More

Cataract Quiz: When did the break happen?

This patient has a relatively dense cataract and requires a toric IOL for 2 diopters of regular corneal astigmatism. When … More

Incisional Techniques for Astigmatism

Cataract surgery can be our most powerful refractive surgery procedure, correcting high degrees of myopia, hyperopia, and even astigmatism (with … More

Toric IOL for Posterior Polar Cataracts?

We know that with posterior polar cataracts, there is a congenital weakness in the posterior capsule at the site of … More