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

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

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

1730: belt loop to fixate Ahmed segment

This patient sustained ocular trauma which resulted in loss of zonular support for about 180 degrees, allowing tilt and decentration … 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

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

1686: dense cataract iris & zonular loss

This case is beyond 10 out of 10 in difficulty and our guest surgeon, Dr Steve Safran, is a true … 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

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

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

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

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

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

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

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

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

1232: traumatic loss of zonular support

This patient sustained severe ocular trauma that resulted in loss of more than 180 degrees of zonular support. He has … More

1144: white cataract intra-capsular surgery

Decades ago the standard cataract surgery was an intra-capsular cataract extraction. This involved making a large incision, injecting alpha chymotrypsin … More

1133: Capsule grabbed with phaco probe

Ideally, you want the tip of the phaco probe to stay in the central zone of the anterior segment and … More

1068: sutured capsular tension segment

This patient was born with a lens coloboma where part of the crystalline lens did not develop and there is … More

1053: that’s not cortex you’re pulling!

In this anonymously submitted video, we see that if the capsule is inadvertently grabbed by the suction from the I/A … More

This subtle sign indicates weak zonules!

This is a very subtle sign — looking at this title pic, we see a demarcation line just inside the … More