Intumescent white cataracts pose a challenge because the lens cortex has degenerated so much that is has liquefied. This creates … More
Tag: #cataract surgery
Pars plana anterior vitrectomy
The only ophthalmologists who have zero surgical complications are those who don’t operate and those who are not fully truthful. … More
Quiz: Why are there two main incisions?
Cataract Quiz: Why are there two phaco incisions in this eye? This is a routine cataract surgery and the case … More
Tough posterior capsule opacity
When a patient presents with a dense posterior sub-capsular cataract and there is difficulty removing all of the opacity, how … More
Cataract Surgery in Silicone Oil Eyes
Retina surgeons will occasionally use silicone oil to help keep the retina in position during healing and in rare cases, … More
Review: fixing beginner mistakes
Learning intra-ocular surgery is not easy and it can take years just to be comfortable with just the basics. Look … More
The Subtleties of Cataract Surgery
The difference between good cataract surgery and great cataract surgery comes down to subtleties. There are very slight nuances to … More
Bilateral brunescent cataract surgery
This patient has been functionally blind for 10 years and presents to us with bilateral, dense, brunescent cataracts. We must … More
Quiz: What is different about this cataract?
Look carefully at the picture above and you will see something that is different about this white cataract. It is … More
Resident Cataract Surgery Final Exam
Today is June 30 and that is the final day of residency training in the USA since our academic year … More
Analysis of Resident Surgery Steps
This video features side-by-side double camera angles so that we can simultaneously see the microscope view as well as the … More
Fluidic Analysis during Phaco Chop
It can be helpful to see the machine fluidic parameters in real-time as the phaco chop procedure is performed. We … More
Review: capsule attachments with femto-laser
This young patient (about 40 years old), developed a white cataract which has severely impaired vision in this eye for … More
Paired Incisions to fix Astigmatism
This is an easy technique that can be so helpful to all cataract surgeons. By using paired phaco incisions, we … More
Pearls for small pupil cataract surgery
There are some great surgical pearls for dealing with small pupils during cataract surgery and this video explains some of … More
Cataract Quiz: Why shift the capsulorhexis?
Looking at the picture above it seems like the capsulorhexis has been shifted nasally: it is much closer to the … More
Complete Case: Cortical Cataract
With a cortical cataract, patients are very symptomatic, particularly if the cortical opacities are within the visual axis. These tend … More
Resident Case Double Camera Angles
For experienced surgeons (which I define as those who have done at least a few thousand cataract surgeries), the microscope … More
Complete Case: a very special patient
As a surgeon, it is always an honor when a colleague trusts you to operate on his eyes or on … More
Review: Cataract surgery after prior RK
This patient was very myopic and desired surgical correction many years before the advent of the excimer laser. As such, … More
Use Trypan Blue dye before OVD
Trypan Blue dye is very useful in cataract surgery because it can stain the anterior lens capsule which improves visualization … More
Complete Case: loose zonular support
Another great video in our series of Complete Cataract Cases: a dense cataract in the setting of loose zonular support. … More
Anterior Capsule Rips Uncontrollably
Quiz time: What do you do when the anterior capsule rips uncontrollably in a young patient who is scheduled to … More
Complete Case: vertical phaco chop
Another complete cataract case, this time showing the vertical chop technique to split the cataract into two halves. This is … More
Resident surgeon does case #100
For all of our young surgeons who are learning cataract surgery, this is a great video because it shows you … More
resident toric IOL case double camera angles
Using double camera angles can help newer surgeons learn the nuances of surgery. This video shows a resident surgeon who … More
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. … More
Should you do surgery for this patient?
This is a complex patient who has many systemic medical issues and because her lab tests from this morning showed … More
Complete Case: Efficient Phaco Chop
Another great video in our series of Complete Cataract Cases. You’ll be able to learn from the very first incision … More
Quiz: Should I have used a pupil ring?
This is a tough case and the pupil is smaller than I expected. Should I have used a pupil expansion … More
2 approaches to Posterior Polar Cataracts
Studies have shown that 1 out of 3 posterior polar cataract surgeries result in a ruptured posterior capsule. Here’s the … More
Pre-Chop with just 2 Choppers
Guest surgeon Dr Valentin Apostolov from Amsterdam shows us his technique for splitting a dense nucleus into small fragments before … More
From routine case to disaster in 1 second
When I first saw this video, which was submitted by an anonymous surgeon, I was in disbelief. I simply could … More
Review: The Angle of Approach for Incisions
The angle of approach of the keratome will determine the tunnel length of our phaco incision. If the angle is … More
Tough cataract case for a resident
We are thankful for the many video submissions we receive from our readers, particularly from residents or registrars who are … More
Lessons Learned with 3-piece IOLs
Most cataract surgeons now use single-piece acrylic IOLs for the majority of their cases, with three-piece IOLs reserved for unusual … More
Cataract Quiz: IOL with capsule tear
Cataract Quiz time: you have removed the lens nucleus and the cortex and you see that the anterior capsular rim … 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
Complete Case: Floppy Iris & Loose Zonules
There is a benefit to watching a video of a complete cataract case, from start to finish. This is particularly … More
Recovering from Argentinian Flag Sign
We have an entire section devoted to achieving success with white cataracts, including intumescent white cataracts. But even in expert … More
Cataract Surgery in MegaloCornea
This patient has a huge cornea with a diameter of about 14 mm and an equally large anterior segment including … More
Staying calm when you see danger signs
The second that I see this round hole, I know that it is a danger sign. We have previously explained … More
Cataract Quiz: Which direction for capsulorhexis?
In this Cataract Quiz we have a patient with a white cataract and as we start to tear the capsulorhexis, … More
Should you use a trifocal IOL in Fuchs’?
This is an unusual case: the patient has Fuchs’ Corneal Dystrophy and yet we are implanting a trifocal IOL. Usually, … More
Intra-scleral Gore-Tex IOL fixation
This young patient sustained severe ocular trauma a few years ago and he had a surgical repair done in another … More
Descemet Membrane Detachment
When we make a phaco incision that involves the cornea, there is always a risk of having focal detachment of … More
Review: Small Eye with high power IOL
Cataract surgery can provide an incredible refractive result, particularly for small eyes which are highly hyperopic. We can correct 10 … More
Double Hydro-Delination Technique
Hydro-delineation is a useful technique which allows us to separate a central endo-nucleus from an epi-nuclear shell. In this case, … More
Cataract Quiz: What do you do now?
This is a complication that is sure to happen to every beginning cataract surgeon: a broken posterior capsule as a … More
Complete Case: PXF supra-capsular chop
The previous case (reference 611) from yesterday, showed the first eye of this patient where the technique was phaco chop … More
Complete Case: PXF chop in the bag
Today (video 611) and tomorrow (video 616) are the two eyes of the same patient who has pseudo-exfoliation syndrome and … More
Hydro-delineation makes chopping easier
Performing hydro-delineation helps to separate the denser, central endo-nucleus from the softer epi-nuclear shell. This endo-nucleus is smaller in diameter, … More
Review: Chopper protects the capsular bag
We work in a very tiny space of just a fraction of a milliliter: the volume of the anterior chamber … More
Fixate the eye with your other hand
The problem with using two hands to hold the capsulorhexis forceps is that you lose the ability to have the … More
Examine instruments before using them
We must examine our instruments before using them to ensure that they are intact and in normal, working condition. In … More
Show me a beautiful cataract surgery
Here on CataractCoach.com we have hundreds of teaching videos, and many of them are of very complex or complicated cases … More
Review: Embed the phaco tip without ultrasound
This review is particularly important for ophthalmologists who do cataract surgery for patients with mild to moderate nuclear density. This … More
Pre-Chop Variations for Cataract Surgery
In this video, submitted by Dr. Yaun Lin from Casablanca, Morocco, we can learn multiple different variations of Pre-Chop. This … More
Expulsive Choroidal Hemorrhage!
This video is a MUST SEE! An expulsive choroidal hemorrhage is a rare complication than any cataract surgeon must be … More
Cataract Quiz: Chopper breaks zonules
The resident surgeon has good hands and is talented, but like all new surgeons, he is lacking in experience. The … More
Posterior capsule rupture – finish the case
This resident case is a challenge: the posterior capsule is ruptured but there is still cortex to be removed. Can … More
Benchmark: Senior Resident Chop
This is a good benchmark for what a senior resident should be able to achieve by the end of residency … More
Seems like a good chop but…
Another video for our series of Complete Cataract Cases, we present a surgery of me operating. During this surgery, I … More
Lens Snare Technique
More than a decade ago in 2009, Dr. Bhattacharya in India described a way of using a lens snare to … More
Cataract Quiz: Why did this IOL decenter?
The patient underwent a combined cataract surgery with pars plana vitrectomy. The cataract surgery went well and even today, 1 … More
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 … More
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 … More
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 … More
IOL delivery technique
While it seems relatively easy to insert the IOL with an injector system, there are subtleties in the technique which … More
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. … More
List of Key Videos for Residents
A young doctor in training asked me to put together a list of key videos prior to her first day … More