1830: trust yourself but question computers

I recently performed a cataract surgery case using a heads-up electronic display where the computer would overlay a precise circle … 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

1782: resident week: cystotome rhexis

The simple bent needle, also called a cystotome (or cystitome for the alternate spelling) can be used to create the … More

1765: keep the capsulorhexis centered

In this complete cataract case the pupil has dilated in an asymmetric manner. There is no history of trauma and … More

1687: ensuring capsular overlap of optic

In cataract surgery we are taking out a 4 to 5 mm thick human crystalline lens and replacing it with … More

1654: this capsulorhexis will radialize

Looking at this picture, the capsulorhexis appears to be proceeding well. It is round and intact and the resident is … More

1636: capsulorhexis challenges

This video features some challenges that I faced during capsulorhexis creation in seemingly routine cataract cases. Yes, even experts with … More

1609: Curriculum Lesson 7: Capsulorhexis

The capsulorhexis. One of my favorite parts of cataract surgery and one of the hardest steps to learn. When you … More

1579: phaco through small capsulorhexis

The double capsulorhexis technique is very useful for intumescent white cataracts because it allows us to safely decompress the capsular … More

1562: capsulorhexis considerations

As a beginning surgeon, the capsulorhexis is one of the hardest steps of cataract surgery to learn. The anterior capsule … More

1465: MSICS: bailout for rhexis runout

MSICS can be a great way to rescue a very difficult case. We recently presented a video of a master … More

1457: small capsulorhexis leads to trouble

This is another case where the capsulorhexis is about 4 mm in diameter and this causes a complication where the … More

1456: operating through a small rhexis

Keep in mind the dimensions of the typical cataractous lens: about 9-10 mm in diameter and then about 4-5 mm … More

1444: the patient moved during the rhexis

As I am performing the capsulorhexis, the patient unexpectedly moved and there is a run-out of the capsule tear. The … More

1420: cystotome capsulorhexis

Beginning residents are amazed when they see that a complete capsulorhexis can be completed with just a cystotome. Using just … More

1418: advantages of Zepto capsulotomy

There are many ways of performing the steps of cataract surgery. We can do the capsulorhexis / capsulotomy with a … More

1414: white cataract, small capsulorhexis

A small capsulorhexis can pose a big challenge during cataract surgery. Keep in mind that a typical human cataractous crystalline … More

1400: handling the run-out capsulorhexis

The capsulorhexis has a tendency to run-out if the anterior lens capsule is insufficiently flattened, if there is any posterior … More

1387: Zepto Precision Pulse Capsulotomy

The Zepto device uses a brief pulse of electricity to instantly create a precision capsulotomy in the anterior lens capsule. … More

1362: keratome to start the capsulorhexis

Our guest surgeon has an interesting technique where he uses the keratome to start the capsulorhexis. This saves a step … More

1345: capsulorhexis split – now what?

This patient has a white cataract and this resident is able to perform a successful capsulorhexis after staining with trypan … More

1340: plan your rhexis to avoid opacities

Yesterday’s video (#1339) showed how to move cortical opacities from the path of the capsulorhexis by pushing the liquefied lens … More

1339: you can move cortical spokes

Cortical lens opacities tend to block the red reflex which can make capsulorhexis creation more difficult. Since these cortical spokes … More

1322: femtosecond laser or forceps?

Look carefully at this title photo and tell me which eye had a capsulorhexis with forceps and which eye had … More

1310: why the capsulorhexis matters

The capsulorhexis is a critical step of cataract surgery for two main reasons: it creates a stable and strong opening … More

1294: capsulorhexis in a 5 year old child

The lens capsule changes in elasticity over our lives: it is far more elastic in youth than it is in … More

1255: does rhexis morphology matter?

Does the shape of the capsulorhexis matter? We are accustomed to making a 5 to 5.5 diameter capsulorhexis that is … More

1220: white cataract phaco puncture

This is a resident case of an intumescent white cataract. We have covered this topic many times and the theme … More

1205: how to perfect your capsulorhexis

The capsulorhexis is crucial in cataract surgery because it gives capsular integrity during nucleus and cortex removal and also provides … More

1186: Capsulorhexis danger zones

When I participate in a meeting, I always learn much more than I teach. I recently gave a graduation lecture … More

1172: anterior capsular tear in phaco

The lens capsular bag is fragile and very thin, with an anterior measurement of about 14 microns and a posterior … More

1132: Playlist: white cataract capsulorhexis

Performing a successful capsulorhexis is one of the biggest challenges in eyes with white cataracts, particularly intumescent white cataracts. This … More

1122: Remote Capsulorhexis Training

Prof. John Ferris has started a novel program of remotely teaching young surgeons to improve their surgical skills. This can … More

Playlist: Capsulorhexis

The capsulorhexis is an important step of cataract surgery. It allows us to maintain the strength of the capsular bag … More

measure the capsulorhexis in high myopia

Eyes come in a spectrum of sizes, particularly with the measurements of the anterior segment in patients with extreme refractive … More

Capsulorhexis Pearls

By watching many surgeons, we can learn different ways of performing the same procedure. In this case, Dr Luis Escaf … More

Cataract Quiz: Use the can-opener now?

During capsulorhexis creation, this resident surgeon loses control of the anterior capsule edge and it runs all the way out … More

Spiral Capsulorhexis Technique

After needle decompression of the cataract, using a spiral technique for the capsulorhexis has a distinct advantage: if there is … More

Wrinkled and fibrotic lens capsule

This seemed like a typical white cataract during the pre-operative exam and when first placed under the surgical microscope on … More

Cataract Quiz: Argentinian Flag Sign

Cataract Quiz: How can you prevent the dreaded Argentinian flag sign now? White cataracts can pose a challenge when performing … More

Enlarge the Capsulorhexis

A small capsulorhexis makes nucleus removal more difficult, especially when we have a dense cataract. When the entire lens hardens … More

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 … More