99% of ophthalmologists (including me!) will not be able to figure out the surprise from this picture. If you want … More
Tag: small pupil cataract surgery
2863: using a needle to insert iris hooks
We are always looking for ways to make our surgeries more efficient and safer, and today I want to show … More
2859: injecting trypan blue under the iris
Injecting Trypan blue under the iris: Staining in Small Pupils In cases with posterior synechiae and a non-dilating pupil, the … More
2840: so many challenges for this resident
I am very proud of this resident for sending in this video of case 75, which is quite challenging, with … More
2718: uveitis white cataract & synechiae
Performing cataract surgery in an eye with chronic uveitis presents a triple challenge: a fragile blood-aqueous barrier, dense posterior synechiae, … More
2748: should we do iris sphincterotomies?
Small pupils can significantly complicate cataract surgery by limiting visualization and access to the lens. When pharmacologic dilation is inadequate, … More
2720: How to deal with this small pupil?
Iris hooks are a reliable method for mechanically expanding a small pupil during cataract surgery, especially when pharmacologic dilation is … More
2676: shallow AC with iris prolapse + MIGS
We have all been there to experience iris prolapse in the presence of a poorly dilating pupil, a floppy iris, … More
2640: the secret to get the nucleus out of the bag
In cataract surgery, managing a small pupil presents several intraoperative challenges, particularly in safely prolapsing the nucleus out of the … More
2474: this is going to be a tough case!
This patient has a small eye with a small pupil, shallow anterior chamber, and pseudo-exfoliation. That will make the case … More
2447: small pupil case becomes tough
When dealing with patients who have small pupils or floppy iris tissue, we need to take extra caution. Even then … More
2438: small pupil, shallow AC, stop & chop
I get emails from viewers asking how to see cases where I am the surgeon operating. This is about as … More
2433: anterior capsule tear small pupil case
Another tough case where the patient has a small pupil, a dense cataract, and incessant head moving during surgery. This … More
2367: nanophthalmic eye challenges
We all love performing cataract surgery on average eyes because we know what to expect: an average IOL power, average … More
2292: small pupil phaco without a ring
This patient has a small pupil and cataract surgery will be more challenging in this case. We can use a … More
2244: the challenge of seclusio pupillae
This patient has a complex history: a 58-year-old woman with a history of severe non-infectious panuveitis, presenting with a non-dilating … More
2147: fix narrow angles with cataract surgery
When we replace the 4.5mm thick cataract with a thin IOL, we open the angle of the eye and solve … More
2131: small pupil: ring or no ring?
Our guest surgeon shows us the two eyes of the same patient with each having a similar pupil size and … More
2126: sphincterotomy for a tiny pupil
This patient has a uveitic cataract with a pupil membrane and synechiae which has resulted in a tiny 1 mm … More
2091: small pupil phaco without rings
Our talented guest surgeon does a great job of cataract surgery in a patient with small pupils without using a … More
2047: small pupil, shallow AC, delicate iris
This is a tough case in a patient with prior synechiae, a small pupil, a shallow anterior chamber, and a … More
2003: fix synechiae with a pale blue iris
In my private practice many patients have light colored irides with scant pigmentation. The iris stroma tends to be very … More
1925: pupil stretching is safe, easy, effective
Performing pupil stretching is safe, easy, and effective but there is a delicate balance. Too forceful of a stretch can … More
1920: small pupil pseudo-exfoliation
Our guest surgeon does a great job with this tough case of pseudo-exfoliation with a relatively small pupil. And this … More
1879: small pupil, synechiae, dense cataract
These types of cases where there is a small pupil due to posterior synechiae can be challenging. We must first … More
1855: MSICS with small pupils & weak corneas
All this week we are featuring cases of MSICS: manual small incision cataract surgery. The incision is not all that … More
1850: ASCRS 2023 Course Case 9
On Sunday, May 7, 2023 we had our Best of CataractCoach.com course at the ASCRS meeting in San Diego. It … More
1819: curriculum lesson 22: small pupil & iris prolapse
The next lesson in our 25 part curriculum series is focused on dealing with small pupils and iris prolapse. You … More
1715: capsulorhexis right up against iris
For a case like this where the pupil is mid-dilated to about 5 mm in diameter, be sure to make … More
1680: successful small pupil MSICS
Our guest surgeon has a lot of experience in performing MSICS, even in a tough case like this with a … More
1673: lift the iris in a small pupil case
For patients with smaller pupils, such as this case with about a 4 mm pupil diameter, I tend not to … More
1667: case 2500 small pupil, no ring needed
Many surgeons will see this small pupil and immediate ask for a pupil expansion ring or iris hooks and that … More
1663: resident fixes synechiae small pupil
This small pupil case has a surprise in store for you. The patient has a history of prior uveitis which … More
1662: expansion ring for small pupils
Happy Thanksgiving to my USA followers – my favorite holiday of the year because we express our gratitude for the … More
1632: sphincterotomy & bag handle
The two techniques shown in this video have not been previously featured on CataractCoach and since they are from the … More
1557: small pupil and dense cataract
This is a fun video where I give the commentary while watching it for the first time. The case is … More
1407: challenging uveitic cataract
This patient is monocular and has an opaque cataract that developed in the setting of chronic uveitis. This has cause … More
1392: MSICS with a small pupil
You must be wondering why I have been posting so many MSICS (manual small incision cataract surgery) videos in the … More
1388: small eye, small pupil, dense cataract
This is a very tough case: a small eye with a shallow anterior chamber, a small pupil with iris laxity, … More
1359: pupil stretch without iris damage
We can stretch the pupil using two hooks in order to enlarge a small pupil for cataract surgery. But how … More
1353: this means no pupil ring needed
There are some cases where you absolutely need a pupil expansion ring or iris hooks, such as this case. That … More
1348: pupil stretch, toric IOL, steroid implant
Our guest surgeon Dr Himani Goyal does a masterful cataract surgery for this monocular patient. We are showing the entire … More
1329: pupil expansion with iris speculum
Our guest surgeon today is showing a different type of pupil expansion ring. It is made of metal and it … More
1326: operating through a small pupil
Our guest surgeon is highly talented and from watching this surgery, I suspect has done many thousands of cataract surgeries. … More
1284: Pupil Stretching Works!
Pupil stretching works. And it works well without additional instrumentation or devices. In this example the pupil went from 3.9 … More
1200: small pupil toric IOL case
These are my pearls for implanting a toric IOL and achieving accurate alignment in small pupil cataract cases. These cases … More
1194: phaco use after IOL implanted
This is a tough case for a resident. A smaller pupil with a denser cataract and in an eye with … More
1155: dense cataract, small pupil, MIGS
This is a tough case in an 87 year old patient who has a small pupil, a dense cataract, and … More
1130: Pupil Expansion with B-Hex Ring
If you really want to be honest with yourself, you will agree that the B-Hex pupil expansion ring is amazing. … More
1093: Audience Poll: Pupil Ring or Not?
This is the maximum pharmacologic dilation of about 4mm and the patient is noted to be taking tamsulosin (Flomax) for … More