Look carefully at the picture and tell me what you would do differently for this cataract surgery. This patient has … More
Category: unusual cases
The Most Extreme Myopia that I’ve seen in 20+ years
An average eye has an axial length of about 23 to 24 mm, but this patient had an axial length … More
Guest Cataract Surgery: Tiny Pupil with Synechiae
This patient had a prior uveitic episode which resulted in the formation of posterior synechiae, where the iris, at the … More
Surgical Peripheral Iridotomy using 23g Vitrector
There are times when you will need to make a surgical iridotomy either during cataract surgery or as a stand-alone … More
Small Pupil, Dense Cataract, Corneal Scar, Glaucoma
The key to approaching a difficult surgery is to use a stepwise approach. In the case presented here, we have … More
Bleeding in the Anterior Chamber during surgery
It is unusual to encounter bleeding in the anterior chamber during cataract surgery, but rarely it does happen. The typical … More
Quiz: Why does the IOL optic look cloudy?
This patient had cataract surgery with the same IOL about 18 years ago and she did very well for many … More
Cataract Surgery after Prior Uveitis Issues
Doing cataract surgery in an eye with a prior history of uveitis can be more challenging than a typical case. … More
Cataract Surgery in Pigment Dispersion Syndrome
Cataract surgery in patients with Pigment Dispersion Syndrome can be challenging due to the anatomic changes which have happened over … More
Should we do bilateral same-day cataract surgery?
On rare occasions, I will do immediate, bilateral sequential cataract surgery so that a patient can have both right eye … More
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
Treating Iris Bleeding during Cataract Surgery
Typically, modern day phacoemsulification cataract surgery is relatively bloodless because we are making incisions in the cornea and then operating … More
Hidden Nuclear Fragment during Cataract Surgery
When we break up the cataract during phaco surgery, we create many small little pieces which are then aspirated from … More
Ocular Albinism Cataract Surgery
Ocular albinism poses a number of challenges for cataract surgery. The patient often has concomitant nystagmus, underlying amblyopia, macular issues, … More
Cataract Surgery in Retinitis Pigmentosa
While retinitis pigmentosa is considered a rare disease, it occurs with enough frequency that every cataract surgeon will encounter it … More
Soft Posterior Polar Cataract Technique
This is a patient with a history of high hyperopia (+7.5 of hyperopia) and posterior polar cataracts since childhood. The … More
Cataract Surgery with Traumatic Zonular Loss
Are you ready for a challenge? This patient is a relatively young construction worker who sustained a blunt traumatic ocular … More
Cataract Surgery with Glaucoma Shunts
Los Angeles is an amazing city which is very diverse and when I am teaching the UCLA ophthalmology residents, we … More
Removal of a Posterior Capsule Plaque
When we remove the cataractous lens there is sometimes a posterior plaque that is adherent to the capsule. How do … More
Surgical Approach for a Morgagnian Cataract
With a white cataract, typically the cortical layers opacify and may partially liquify, and that can make the surgery more … More
Cataract Surgery after Prior Vitrectomy
Cataract surgery in an eye which has undergone a prior pars plana vitrectomy is different in many ways, including lens … More
Cataract Surgery in Marfan Syndrome
Patients with Marfan Syndrome have a congenital, progressive weakness in the zonular structures which support the crystalline lens. As such, … More
Preventing and Treating Capsular Phimosis
The capsular bag contracts when we remove the thick cataract (4+ mm thick) and replace it with a thin IOL … More
Salzmann Nodules and Cataract Surgery
Salzmann nodules occur at the limbus or peripheral cornea and can disrupt the ocular surface, even causing an irregular ocular … More
Quiz: Persistent Corneal Edema – Why?
This 70 year old patient had successful cataract surgery about one month ago. There were no complications. The patient has … More
Efficient Cataract Surgery for Spastic Patient
Rushing during surgery, especially cataract surgery, is a bad decision. It can lead to complications which can cause a poor … More
Cataract Surgery in Fuchs’ Corneal Dystrophy
Fuchs’ endothelial dystrophy is a disorder in which the corneal endothelium becomes progressively weak, leading to corneal decompensation and decreased … More
Complex Cataract: multiple challenging issues
This patient had a large rhegmatogenous retinal detachment repaired a few years ago with a successful pars plana vitrectomy. The … More
Why is phaco chop not working here?
This patient certainly needs cataract surgery because the dense nucleus has a large degree of central opacity and that has … More
A Cataract is not always what it seems…
Since we’ve spent so many years studying ophthalmology, the subtleties of our field become second nature to us. We can … 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