This young patient has a developmental cataract which has worsened over the last year and now significantly obscures the patient’s … More
Category: unusual cases
2345: IOL scaffold for Morgagnian cataract
The idea behind the IOL scaffold technique is to use the large 6 mm optic of the IOL as a … More
2333: the monocular patient mindset
Monocular patients are justifiably nervous with discussions about operating on their only good eye. These patients are worried that in … More
2325: cataract surgery in corneal ectasia
This patient has a complex ocular history which includes a high degree of axial myopia which was treated with LASIK … More
2321: ectopia lentis from homocystinuria
There are certain rare diseases, such as Marfan syndrome and homocystinuria, which lead to progressive zonulopathy with subluxation of the … More
2306: K-Pro kerato-prosthesis
The K-Pro (kerato-prosthesis) is a device intended for very complex cases of anterior segment reconstruction where a traditional corneal transplant … 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
2296: artificial corneal endothelial implant
In our podcast from yesterday, Dr David Lockington explained how he has used an artificial corneal endothelial implant in complex … More
2269: intra-lenticular foreign body
This is a rare case that I have never personally experienced, but you may in the future. The patient reports … More
2247: enhanced corneal ectasia treatment
Yesterday’s CataractCoach Podcast featured Prof. Renato Ambrosio, Jr, MD, PhD who is a true world expert in corneal ectasia, keratoconus, … More
2244: the challenge of seclusio pupillae
This patient has a complex history: a 58-year-old woman with a history of severe non-infectious panuveitis, presenting with a non-dilating … More
2222: Quiz: what’s your approach?
This patient was sent to you for cataract surgery. What is going on here? What is your approach? Look carefully … More
2216: Implantable Mini Telescope IMT
This patient has severe macular degeneration which has rendered the central visual acuity to 20/200 or worse. Our guest surgeon … More
2207: cataract surgery with coloboma
In this tough case the patient has a visually significant cataract but also a congenital coloboma which you can see … More
2167: Hashtag suture to stabilize the IOL
This young patient has Marfan Syndrome and previously underwent pars plana vitrectomy and lensectomy for a dislocated crystalline lens with … More
2161: Quiz: What type of cataract is this?
This patient developed this condition over the past 6 months to 1 year and now presents to your clinic with … More
2151: microspherophakia cataract surgery
This is a tough case where the patient has an unusual eye with a very small anterior segment but a … More
2133: surprise true capsular exfoliation
This is a very rare case that I have never encountered in my career: a true capsular exfoliation where there … More
2095: irido-zonulo-hyaloido-vitrectomy
This patient has malignant glaucoma and to treat that the procedure is IZHV: irido-zonulo-hyaloido-vitrectomy. Here is what our guest surgeon … More
2067: challenges with ocular albinism
While ocular albinism is a rare condition, every cataract surgeon will encounter this condition over the course of a career, … More
2052: What is lens sparing cataract surgery?
At the EPOMEC 2023 meeting in Dubai, I had the pleasure of being on a speakers panel with Prof Fathy … More
2025: seated upright phaco surgery
This patient has severe orthopedic spine issues along with other systemic medical conditions which prevent him from being in the … More
2020: removing calcified lens cortex
This is a very difficult cataract case: the anterior capsule is fibrotic and wrinkled and there is calcified cortex that … More
1989: anterior zonular attachment
This is a very rare case which I have seen in less than 1 out of 1000 cataract surgeries. This … More
1956: Morgagnian cataracts are challenging
A Morgagnian cataract is one where the cortex has completely liquefied and the remaining endo-nucleus is floating around in the … More
1936: corneal intacs intra-stromal ring segments
Surgeons have tried many techniques to address refractive errors by altering the cornea and there will likely be many more … More
1908: nanophthalmos & decompression
This patient has true nanophthalmos with an axial length of less than 20mm and a calculated IOL power of 67 … More
1907: asteroid hyalosis & cataract surgery
Asteroid Hyalosis is seen in about 1-2% of your cataract surgery patients and it is most often unilateral. These focal … More
1904: conductive keratoplasty CK cataract
More than 20 years ago, a new technology was unveiled to help address presbyopia: conductive keratoplasty (CK). This used electrical … More
1878: depot steroid implanted in the lens
This depot steroid device was supposed to be injected into the vitreous cavity, but it ended up inside the crystalline … More
1877: cataract with severe corneal pannus
This patient sustained a chemical burn to the ocular surface and then underwent a limbal stem cell transplant procedure for … More
1862: nanophthalmic eye cataract surgery
Experienced cataract surgeons know that the most challenging cataract cases are often the nanophthalmic eyes. These tiny eyes have a … More
1859: MSICS with iris & lens coloboma
This is a tough case of a dense cataract in a patient with an iris and lens coloboma. This means … More
1837: phaco & irido-zonulo-hyaloidectomy
This nanophthalmic eye has an axial length of less than 20 mm and is suffering from malignant glaucoma and aqueous … More
1807: annular cataract with scarred capsule
It is very unusual to see this type of annular cataract where the remaining lens material is in the shape … More
1785: centrally attached zonular fibers
This is an usual case where there are zonular fibers which are centrally attached onto the anterior lens capsule, so … More
1744: keratoglobus cataract surgery
Keratoglobus is a rare condition, so rare that I have never seen a patient with this condition in my career, … More
1725: coloboma with capsule rupture
Yesterday we featured a case of cataract surgery in a patient with a coloboma. And today we have another similar … More
1724: coloboma with zonular absence
Today and tomorrow we are featuring cases with congenital colobomas where there is an absence of part of the iris … More
1718: Marfan syndrome subluxed lens
Marfan syndrome patients develop a progressive zonulopathy with subluxation of the crystalline lens which leads to visual decline. While still … More
1717: bilateral phacomorphic glaucoma
This is a very unusual case of bilateral phacomorphic glaucoma where the swollen cataract caused the narrow angles to occlude. … More
1701: don’t just break synechiae, fix pupil
This patient had a prior history of anterior uveitis which resulted in the formation of synechiae from the iris to … More
1698: phaco trabeculectomy with leukoma
This is a very tough case because the patient has a long-standing corneal scar, a cataract, and glaucoma that is … More
1645: phacolytic glaucoma & synechiae
Our guest surgeon does a great job with a very difficult cataract surgery. The patient has phacolytic glaucoma where the … More
1640: anterior capsule plaque peeling
Our guest surgeon presents a case of a dense cataract where the cortical lens proteins broke down and caused a … More
1631: Marfan Case with Yamane IOL
In cases where the surgeon performs Yamane intra-scleral haptic fixation (ISHF) it is recommended that at least a partial anterior … More
1626: considerations for monocular patients
Of the overall cataract surgery volume, perhaps less than 1% of those patients are truly monocular and maybe less than … More
1615: micro-cornea and coloboma
This is a very unusual case where the patient has a micro-cornea and also a coloboma with associated zonular absence … More
1610: poly-pseudophakia 2 IOLs in 1 eye
Nanophthalmic eyes are among the most challenging when it comes to cataract surgery. There are additional risks and the working … More
1591: asteroid hyalosis of the vitreous
We have all seen it before: thousands of small, white, refractile bodies floating in the vitreous cavity with seemingly little … More