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.

In this patient with severe claustrophobia and a moderately shallow AC, I discuss several maneuvers/techniques that can reduce patient anxiety and increase the safety of nucleus removal.

A patient with dysphotopsia requiring IOL exchange has had a prior Yag laser posterior capsulotomy.  After performing a pars plana vitrectomy, a secondary capsulorhexis is demonstrated followed by IOL exchange with optic capture.

In this case, I demonstrate how varying the vacuum setting from 400 to 600 mmHg affects the rate of quadrant removal during phacoemulsification.

Phacoaspiration (no ultrasound) of a nuclear cataract with IOL insertion is performed in a 64 year old patient, followed by trabecular meshwork bypass stent injection.  A second example of stent injection in another patient is also shown.

While performing phacoemulsification on a dense nuclear cataract in a 91 yo, one-eyed, Flomax patient, the nucleus is observed to shift somewhat posteriorly. During the remainder of this complex procedure I demonstrate techniques that can be used to increase safety as the remaining nuclear and cortical material are successfully removed prior to implantation of a capsular tension ring and toric IOL.

In this case I perform sutured iridoplasty to reduce the size of an enlarged pupil using the Siepser technique to alleviate debilitating glare in a pseudophakic eye with recurrent iritis.