The surgery seems perfect, the IOL is centered, and the cortex is clear but as you hydrate the incisions, you … More
Category: zonulopathy
2900: missing CTR in nanophthalmic eye
Operating on a nanophthalmic eye with a 14 mm axial length is one of the most challenging scenarios in ophthalmic … More
2893: MSICS with Severe Zonulopathy
MSICS: Managing Total Bag Loss and ACIOL Placement When performing Manual Small-Incision Cataract Surgery (MSICS) on a dense white cataract, … More
2886: extensive zonulopathy from trauma
This is a very challenging case where the patient sustained severe trauma. In this title picture you can see at … More
2879: intra-capsular MSICS & scleral fixated IOL
In cases of severe phacodonesis, where zonular support is nearly non-existent, a standard extracapsular approach often risks complete lens dislocation. … More
2874: Morgagnian cataract with zonulopathy
A Morgagnian cataract (named after Giovanni Morgagni the Italian father of anatomic pathology from the 1700s!) represents a very late … More
2870: pupilloplasty & capsular bag fixation
This video features our talented guest surgeon performing two tough cases, both with a pupilloplasty and each doing a different … More
2852: subluxated cataract requires ICCE
There was a time many years ago (40+ years ago) where the standard procedure for cataract surgery was to perform … More
2849: lens coloboma with deformed capsule
Surgery for a congenital lens coloboma is challenging because the deformed capsular bag can lack focal, essential structural support. In … More
2835: Extensive Lens Coloboma
Performing cataract surgery in the presence of a lens coloboma with 180° of zonular absence requires a careful approach to … More
2830: Quiz: What is this line near the iris?
Time for another CataractQuiz, our series where we test your knowledge and skills by showing you a title pic and … More
2822: How to suture Cionni rings to sclera
To fixate a Cionni Modified Capsular Tension Ring, we must anchor the eyelet to the sclera, typically 1.5 to 2.0 … More
2821: severe trauma eye reconstruction
Management of high-grade traumatic iridodialysis requires meticulous surgical intervention to mitigate the functional morbidity such as debilitating photophobia. Our goal … More
2818: zonulopathy & iris clip phakic IOL
Operating on a highly myopic eye with a pre-existing iris-claw (Artisan/Verisyse) phakic IOL and zonular instability requires a sophisticated, staged … More
2793: solar eclipse sign indicates zonulopathy
One of the most subtle yet important intraoperative clues to zonular weakness is the presence of a crescent-shaped, abnormally bright … More
2783: imaging shows severe zonulopathy
Severe zonulopathy with marked phacodonesis requires early mechanical stabilization of the capsular bag to permit safe cataract surgery. After creating … More
2773: global zonular laxity and weakness
Our guest surgeon, Dr Sergio Kwitko from Brazil, is superbly talented at complex anterior segment surgery and he presented this … More
2754: Monocular patient with a surprise
Our guest surgeon does a great job of managing surprise zonulopathy encountered during cataract surgery in this monocular patient. Discovering … More
2734: zonular loss and vitreous prolapse
This is a very tough case of a traumatic cataract with zonular loss and vitreous prolapse into the anterior chamber. … More
2719: traumatic cataract with zonular loss
This is a very tough case because of the prior trauma which has resulted in severe zonular loss and a … More
2706: get rid of that loose, old bag!
In cataract surgery with severe global zonulopathy and marked phacodonesis, complete removal of the capsular bag may be necessary to … More
2692: Quiz: Why is the epi-nucleus stuck?
Time for another CataractQuiz™: Look carefully at the title picture and ask yourself why the epi-nucleus stuck despite good vacuum … More
2691: This just happened. Now what?
Our anonymous surgeon notices a very clear red reflex in this quadrant during cataract surgery. What is happening in this … More
2678: aphakic with zonulopathy, now what?
This patient had cataract surgery about 2 months ago and when the original surgeon was removing the cataract, zonulopathy was … More
2669: Quiz: What does this sign mean?
You are about to start doing phaco chop for this white cataract and you notice that the capsulorhexis is no … More
2661: surprise zonular compromise
This is a great case showcasing the talents of a fantastic surgeon who notices zonulopathy during phaco of a dense … More
2620: two very challenging cataract cases
Our guest surgeon is Professor Ramesh Ayyala and in this video he presents two tough cataract cases which were performed … More
2572: hereditary lens subluxation
When we see hereditary lens subluxation in a younger patient, we should think of systemic conditions which can be associated … More
2571: zonular loss noted in cortex removal
In this resident case, you can clearly see zonular loss during cortex removal but you could have also seen it … More
2570: Quiz: Why doesn’t the IOL center?
Time for another CataractQuiz™: The case seemed routine and proceeded well without any issues. Then you implanted the toric IOL … More
2565: traumatic cataract with dye leak
This patient sustained an ocular injury which resulted in a traumatic cataract with zonulopathy. In these cases, my first step … More
2562: cataract with global zonular laxity
What is the best way to perform cataract surgery when the patient has global zonular laxity? When all of the … More
2559: two cases of fixing zonular defects
Our guest surgeon has submitted two cases of fixing zonular defects during cataract surgery. In one case the zonulopathy appears … More
2535: Quiz: What are all these ‘floaters’?
The CataractQuiz™ series is very popular among CataractCoach™ fans and today we have a good one. The patient in the … More
2534: fixing severe zonular loss
Our guest surgeon does a fantastic job with this very difficult cataract case. You can see in the title picture … More
2529: Quiz: What does this sign predict?
CataractCoach™ fans just love the CataractQuiz™ series and today we have one that you MUST know. Look at the picture … More
2528: traumatic zonulopathy & mydriasis
Traumatic eye injuries can be very challenging because often we do not know the full extent of the damage until … More
2488: trying to remove cortex but then this
Looking at the title picture, we all feel a little pain. This happens to all surgeons at some point: we … More
2487: femto cataract with zonular absence
In most cataract surgery cases, the femtosecond laser does not offer any advantage over a proper capsulorhexis performed by an … More
2432: fix zonular loss with CTS + Goretex
This is a tough case of a traumatic cataract with about half of the zonular support being compromised (6+ clock … More
2429: MSICS for PXF with zonular loss
This patient has severe pseudo-exfoliation and you can tell from the pre-operative photo that there will be extensive zonulopathy. The … More
2328: saving the capsular bag in ectopia lentis
This patient has ectopia lentis with severe subluxation of the crystalline lens. Our guest surgeon does a great job of … 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
2310: fluid misdirection from zonulopathy
Compared to methods of manual cataract extraction, phacoemulsification offers so many benefits such as a smaller incision, a higher margin … More
2256: Quiz: Where is the red reflex?
Time for another Cataract Quiz: You are doing phaco for this patient with a traumatic white cataract and everything seems … More
2255: zonular loss noted during phaco
You are performing phaco chop for this patient with a white cataract and as you start to remove a nuclear … More
2248: the challenge of iris colobomas
When we see an iris coloboma, we should also think of other ocular structures that can be affected by this … More
2233: you start to chop & the rhexis moves
Yesterday’s informative CataractCoach podcast featured Dr Gary Wörtz and we spoke about a challenging case that he recently completed. This … More
2224: using 10 capsular/iris hooks!
This patient has severe pseudo-exfoliation with almost zero capsular support. When the surgeon attempts to start the capsulorhexis, the entire … 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