Look carefully at the title photo and let me know what you think is going on with the CTR? What … More
Tag: weak zonular support
2112: severe anterior capsule phimosis
This patient has severe capsular phimosis which happens where there is weak zonular support and aggressive contraction and fibrosis of … More
2083: Quiz: how to manage zonular dialysis?
Look at the picture here and you will see a red reflex indicating a quadrant (or more) of zonular laxity … More
2082: traumatic cataract CTR placement
Our guest surgeon presents a case of a traumatic cataract with zonulopathy. A capsular tension ring is implanted prior to … More
2077: what is an intra-cap cataract surgery?
I received a couple of emails from young surgeons asking to explain the difference between intra-cap, extra-cap, and MSICS cataract … More
2044: re-op of tough pseudo-exfoliation
Pseudoexfoliation affects only a small percent of patients undergoing cataract surgery, but it is important to recognize because it poses … More
2040: Ahmed segment secured with Gore-tex
This patient presents with a traumatic cataract with extensive zonular loss which means that simply placing an IOL within the … More
2018: dislocated IOL replaced with ACIOL
Looking at this title pic, you can see a large degree of capsular phimosis. This progressive constriction of the capsulorhexis … More
2005: pseudo-exfoliation triple surgery
This is a VERY difficult surgery and truly requires expert hands to achieve an excellent outcome. Our guest surgeon does … More
1991: zonular weakness during capsulorhexis
Look at the photo here and you just know that the zonular support is globally weak. There are radial wrinkles … More
1989: anterior zonular attachment
This is a very rare case which I have seen in less than 1 out of 1000 cataract surgeries. This … More
1967: behind the scenes traumatic cataract
Our podcast guest yesterday was Dr Brandon Ayres from the Wills Eye Hospital in Philadelphia, USA and explained his stepwise … More
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
1483: challenging case of ectopia lentis
Our guest surgeon, Dr Guillermo Amescua, is an outstanding surgeon at the Bascom Palmer Eye Institute in Miami, Florida, USA. … 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
1422: IOL surgery for ectopia lentis
While having a dislocated crystalline lens is a rare occurrence, it can pose surgical challenges due to the lack of … 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