After routine phacoemulsification and IOL insertion, a spontaneous opening in the posterior capsule is observed without obvious cause.  A small capsulorhexis must then be enlarged to permit reverse capture of the optic of the single piece, trifocal IOL.

A patient with glaucoma and previous LASIK undergoes implantation of recently modified trabecular microstents after cataract extraction with IOL implantation. Stent implantation technique, post-refractive surgery IOL calculation methods, and persistent leakage from the clear corneal incision caused by the “flipped lip syndrome” are demonstrated and discussed.

Phacoemulsification of a mature, white cataract is performed.  The morphology of the anterior capsule (flat vs convex) and its impact on the capsulorhexis procedure are discussed.

Methods to reduce endothelial trauma, deal with a floppy iris, and determine IOL power in a keratoconic eye with a shallow chamber and floppy iris are presented.

Phacoaspiration is performed in a 40 year-old patient.  Obtaining an intact capsulorhexis was more difficult because of pre-existing subcapsular fibrosis.

Here we depart from our usual presentation of intraocular microsurgical procedures and techniques . A very elderly patient with early phthisis bulbi, and a blind and extremely painful eye receives a retrobulbar alcohol injection to immediately relieve her intractable pain. The appropriate alcohol concentration and anticipated outcome is also discussed.

Two weeks after uneventful cataract – implant surgery, an IOL exchange is performed in a keratoconic eye because of a refractive surprise.

In this case of phacoemulsification and IOL insertion performed on a highly myopic eye, several steps are taken to reduce the possibility of surgical complications in a hypersensitive patient.

In this myopic patient with low ocular rigidity, I demonstrate both my phaco chop technique and simultaneous astigmatic correction using a pair of full thickness i.e. Penetrating, Limbal Relaxing Incisions.

In this case I discuss implantation of a trifocal IOL with astigmatic correction.  Ascertainment of proper alignment of the toric IOL at the desired corneal meridian is also demonstrated.