We have previously covered the topic of pseudo-exfoliation (PXF) in detail here on CataractCoach. It is an important topic because…
Do not make a baby capsulorhexis
Making small capsulorhexis makes the cataract surgery more difficult because it limits access to the capsular bag and makes it…
IOL cartridges – which one?
There are many different IOL injector systems from multiple different IOL manufacturers. It is the surgeon’s job to know the…
Review: Why LRIs should be done at the end
Limbal relaxing incisions (LRIs) are useful for treating mild to moderate degrees of corneal astigmatism at the time of cataract…
Cataract Surgery with Asteroid Hyalosis
Asteroid hyalosis is a rare condition where patients have calcifications throughout the vitreous jelly. It occurs in about 1-2% of…
Secret to Chopping Dense Cataracts
For the phaco chop technique, the nucleus is held stationary by the vacuum level of the phaco probe. This is…
Cataract Quiz: What’s your next move?
You are performing routine cataract surgery and then you suddenly notice that the posterior capsule is open and a nuclear…
Ensuring accuracy of A-scan ultrasound
Correlate A-scan & biometry measurements to improve accuracy in IOL calculations. This case shows how disparate measurements can lead to…
Toric IOL technique with a small pupil
The toric IOL is a great option to address astigmatism at the time of cataract surgery. For the toric IOL…
How to Enlarge a Small Capsulorhexis
Making a small capsulorhexis can make the cataract surgery more difficult. It becomes challenging to bring nuclear pieces out of…
Review: Differentiating White Cataracts
You’ve seen the notation in the patient chart: “DWC” which stands for Dense White Cataract, but there is actually a spectrum of cataracts…
Step-by-step: Malyugin Pupil Ring
To perform cataract surgery in an eye with a small pupil, it helps to expand the pupil to a more…
How to recover from a capsule rupture
It happens to all surgeons, and it is much more common in beginning surgeons: rupture of the posterior capsule during…
Cataract Quiz: When did the bag break?
In this anonymously submitted resident video, there is a break in the posterior capsule during cataract surgery. With the assistance…
Do not withdraw infusion with a capsule break
If there is a break in the posterior capsule, withdrawing the infusion will allow the anterior chamber pressure go to…
Glaucoma Seton Drainage Surgery
In cases of intractable glaucoma, implanting a seton drainage device can be a very effective therapeutic option. The seton tube…
Scleral-sutured IOL with GoreTex
This is an unusual case of prior trauma. A 13 year old boy was playing with fireworks and sustained a…
Review: Dispersive vs. Cohesive Viscoelastics
Viscoelastics, also referred to as OVDs (ophthalmic visco-surgical devices), are viscous substances that allow us to make phaco-emulsification easier and…
Capsulorhexis Pivoting
The key to making a great capsulorhexis is understanding the pivoting technique. This allows us to float within the incision…
IOL delivery technique
While it seems relatively easy to insert the IOL with an injector system, there are subtleties in the technique which…
Pit Technique for Dense Cataracts
With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult.…
Complete Case: Soft Cortical Cataract
Another addition to our series on Complete Cataract Cases is this technique for soft cortical cataracts. These cataracts are typically…
Capsulorhexis: Good vs Great
In this picture, the capsulorhexis on the left is good because it is centered, continuous, and an appropriate size, but…
Artificial Intelligence in Ophthalmology
The future is here and John Ladas, MD, PhD gives us a brief lecture about the Rules of the Game…
Review: Why is Phaco Chop not working?
This patient certainly needs cataract surgery because the dense nucleus has a large degree of central opacity and that has…
Toric IOL Alignment Dilemma
In this picture, all of these lines are at the 120 degree meridian, so how do you choose where to…
Leukocoria in a newborn baby
Leukocoria in a newborn baby is an urgent situation that needs immediate attention from an ophthalmologist. The cause of the…
Cataract Quiz: Where should you make the incision?
Our phaco incisions will induce an astigmatic change in the cornea and we can use that to help achieve a…
Complete Case: Cataract in a Small Eye
Looking at this picture, we can see that the corneal diameter is very small compared to the size of the…
How to Evacuate this Hyphema
This patient was struck in the eye with a Champagne cork, which was traveling at a high velocity and hit…
How to Rescue this Capsulorhexis
We have previously discussed the Little Maneuver which is a method of saving a run away capsulorhexis. In this case,…
Review: Pseudo-Exfoliation Cataract Surgery
Pseudo-Exfoliation / Small Pupil / Weak Zonules / Shallow AC (watch video below) A sweet 80 year old patient comes…
Danger: Clear Crescent Red Reflex
When you are mobilizing a dense nucleus and you briefly see a bright, clear, crescent-shaped red reflex, you can be…
Manual SICS with nucleus bisection
SICS is small incision cataract surgery, and it refers to a method of manual expression of the nucleus through a…
Cataract Quiz: What happened here?
Look carefully at this picture: what do you see? There is a three-piece IOL in the sulcus and there is…
The Chopper Push Technique
Watch this video carefully and you will see that the chopper instrument is used just once to create a single…
Complete Case: Chop in the Bag
Again we have a complete case, from start to finish, showing a routine cataract surgery with a phaco chop technique.…
You must learn this before finishing residency
The challenge of residency training is that you have just a limited time to learn surgery. You can read books…
Review: Phaco Incision OCT Analysis
The phaco incision is part of your signature which links you to the patient’s eye forever. Your incision will forever be visible…
Mentally Recovering from Complications
There are only two types of ophthalmologists who never, ever get surgical complications: (1) those who don’t operate, and (2)…
Complete Case: Flomax & Toric IOL
Many of our CataractCoach.com readers have been asking for complete cases, shown from start to finish. There is a lot…
Cataract Quiz: What is hidden in this pic?
Look carefully! There is something that needs to be addressed in this picture — it is not easy to see,…
Cataract Surgery with Pterygium Present
For a patient with both a pterygium and a visually significant cataract, the best option is usually to do the…
Mastering IOL Flange Techniques
In cases of insufficient zonular support, using a flange technique has become popular after Dr Shin Yamane shared his technique…
What are these lines? What is Reflux?
These lines are the posterior capsule which has found its way into the suction port of the I/A probe. We…
Review: Optimizing Cycle Time Efficiency
Establishing a consistent routine in the operating room is the key for both increased efficiency as well as increased safety.…
Posterior Polar without delineation
Posterior polar cataracts are unusual, but certainly every ophthalmologist will see these patients in their own clinics. While most surgeons…
Posterior Capsule Rupture! Now what?
In this anonymously submitted case from a resident surgeon in training, there are many great lessons to be learned. We…
Cataract Quiz: Optic-Iris Capture
Happy New Year! It’s Quiz Time: how do you approach this case with optic-iris capture and a dense fibrotic membrane?…
How much force for hydro-dissection?
When we perform hydro-dissection, how much force is needed? What volume of balanced salt solution is required? What are the…