This is a tough case where the patient has an unusual eye with a very small anterior segment but a … More
Category: unusual cases
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
1568: technique for iris prosthesis
We recently featured a video of a prosthetic iris implant and some CataractCoach fans had pearls to make the procedure … More
1529: prosthetic iris implantation
This patient sustained trauma which caused a cataract but it also resulted in permanent mydriasis with a pupil size of … More
1520: focal traumatic cataract
At the pre-operative consultation for this patient, it was unclear if there was capsular damage associated with this focal opacity. … More
1491: creating a pupil for Axenfeld Rieger
Axenfeld Rieger syndrome is a rare condition where the iris and pupil do not develop correctly in utero and in … More
1489: corneal epithelial bubble
This patient developed a corneal epithelial bubble during cataract surgery. Why did this happen and what should you do now? … More
1488: Fuchs Dystrophy with EDOF IOL
In the past, I was reluctant to implant an EDOF (extended depth of focus) IOL in patients with corneal issues. … More
1469: open sky cataract surgery
There are times where you will want to perform a combination surgery of full-thickness corneal transplant and cataract surgery at … More
1458: phaco for a patient with tremors
I have previously featured a challenging cataract case for a patient with severe tremors due to systemic neurological disease. In … More
1455: cortex removal before nucleus removal
This video shows something that I have never previously seen before: removal of the lens cortex prior to removing three … More
1454: peeling off the pupillary membrane
This patient has a long history of prior uveitis / anterior iritis which caused synechiae where the iris became adherent … More
1453: Quiz: What is your next step?
This is a tough case where the nucleus is very dense and difficult to chop, but the bigger challenge is … More
1448: 3D viewing system in tough cases
Our guest surgeons from France have an innovative use of the 3D viewing systems to help patients with severe postural … More
1440: green reflex canine cataract surgery
This patient has an unusual eye when you compare it to what you are used to. That’s because the patient … More
1422: IOL surgery for ectopia lentis
While having a dislocated crystalline lens is a rare occurrence, it can pose surgical challenges due to the lack of … More
1407: challenging uveitic cataract
This patient is monocular and has an opaque cataract that developed in the setting of chronic uveitis. This has cause … More
1389: posterior capsulorhexis optic capture
Our guest surgeon performs cataract surgery for this 5 year old child with galactosemia and he uses pearls learned from … More