1967: behind the scenes traumatic cataract

Our podcast guest yesterday was Dr Brandon Ayres from the Wills Eye Hospital in Philadelphia, USA and explained his stepwise … More

1963: inadvertent zonular dehiscence

Iatrogenic complications are tough because we blame ourselves for the sequelae of damaging delicate tissues. In this photo you can … More

1935: Cataract Quiz: What is your next move?

Study this title picture carefully and look at the tip of the yellow arrow. What is going on here? And … More

1909: zonulopathy with capsule fixation

This patient has extensive zonulopathy and phacodonesis which is going to make the cataract surgery difficult and also pose a … More

1905: Cataract Quiz: What does this tell you?

Stop reading and look carefully at the title picture here. What does this tell you? Seriously, stop reading and study … 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

1842: ASCRS 2023 Course Case 2

On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More

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

1810: severe zonular loss with Cionni ring

Cases like this are stressful and just looking at this picture should make your heart beat faster. There is a … More

1799: posterior polar with zonular loss

We know that posterior polar cataract cases are challenging because at the site of the opacity the posterior capsule is … More

1787: tilted nucleus with severe zonular loss

This lens is so loose that it is shaking around inside the eye – a severe case of phacodonesis. This … More

1751: for capsule wrinkling, I do this…

This is a complete cataract case, shown start to finish, where the anterior lens capsule wrinkles upon attempted puncture for … More

1745: Ahmed capsular segment placement

This is a tough case where the surgeons learns intra-operatively that there is a quadrant of poor zonular support. An … More

1740: dead capsular bag syndrome

In rare cases, years after a cataract surgery, we can have complete loss of zonular support with dislocation of the … 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

1711: severe PXF and zonulopathy

This is a very challenging surgery and most surgeons would rate it a 9 or 10 out of 10 in … More

1697: what is this loose Gore-Tex suture?

Our guest surgeon, Dr Sara Bozorg, has sent us a very interesting case. This patient had some unknown procedure performed … More

1688: post-trab cataract with weak zonule

The most important take home message in this video is when you see the capsulorhexis moving you should immediately think … More

1670: traumatic cataract with iris damage

This patient sustained ocular trauma which resulted in a traumatic cataract, zonular loss, iris avulsion, and vitreous prolapse. Now you … More

1659: when the anterior capsule wrinkles

Just looking at these two screenshots makes me take a deep breath. The anterior lens capsule is supposed to be … More

1638: surprise zonular weakness

This resident surgeon does a good job with this tough case of a traumatic cataract. The intumescent liquefied lens cortex … 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

1625: aqueous fluid misdirection syndrome

This is my video from the Cataract Spotlight session by Dr David Chang from the American Academy of Ophthalmology 2022 … 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

1614: PXF, shallow AC, DWC, zonulopathy

This is a tough case with many challenges: pseudo-exfoliation syndrome, a shallow anterior chamber, a dense white cataract (with intumescence), … More

1613: Yamane-Kim intra-scleral fixation

Our guest surgeon does a beautiful job of performing the Yamane intra-scleral fixation technique and he takes it one step … More

1551: challenging traumatic cataract

When dealing with a traumatic cataract, the extent of tissue damage is not always fully understood until the surgery begins. … More

1530: intra-scleral flange placement

In the past few years we have seen many advances in IOL fixation using techniques described by Yamane, Canabrava, Oetting, … More

1527: resorbed cataract with zonular loss

This patient sustained trauma to his eye years ago and that resulted in a cataract which, over time, became liquefied … More

1521: when the anterior capsule wrinkles…

Wrinkling of the anterior capsule during the performance of the capsulorhexis can be concerning because it indicates that zonular support … 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

1514: “the toughest case of my life”

“The toughest case of my life” is quite a statement when it is said by a highly experienced, expert level … More

1485: how I know zonular support is weak

Weak zonular support makes cataract surgery far more challenging and increases the potential risks such as vitreous prolapse, retained lens … More

1474: ASCRS case 5: when & how CTRs

Capsular tension rings (CTRs) are important devices that can facilitate cataract surgery in cases where the zonular support is weak … 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

1430: mom of an ophthalmologist

Since our surgery center is in Beverly Hills, I have many celebrities as patients. Multiple actors / actresses who have … More

1423: subluxated cataract & pupilloplasty

This patient sustained an ocular injury which resulted in subluxation of the crystalline lens, cataract formation, and chronic traumatic mydriasis. … More

1421: belt loop technique to secure IOLs

Our guest surgeon, Dr Cathy McCabe from Florida, USA has an innovative way of securing IOLs to the sclera in … More

1401: nucleus division with weak zonules

Our guest surgeon shows two techniques that can be useful in cases where the zonular support is weak. There is … More

1390: CTR insertion with cortex in bag

It is easiest to insert the capsular tension ring (CTR) when the capsular bag is completely empty of lens material. … More

1352: capsular tension rings: when & how

This is my presentation for today, Tuesday, January 18, 2022 at the Hawaiian Eye Meeting and it is a concise … More

1273: that’s not cortex being aspirated…

This is a good learning case, and I am thankful to Dr Amar Kulkarni for submitting it. We see zonular … More

1270: resident microspherophakia

So you’re a resident in training and you watch these CataractCoach videos and think to yourself, “yeah, but when am … More

1266: manual CTR insertion

For cases of zonulopathy, particularly for focal zones of zonular weakness or absence, using a capsular tension ring (CTR) can … 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