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.  

This 38 year old patient has, for his age, an incredibly dense posterior subcapsular opacification. In this case I discuss several pearls for performing cataract surgery on a rather young, semi-conscious patient.

In one of our most requested videos, I use a modified Yamane technique for scleral fixation of a posterior chamber IOL.

This patient developed a dense posterior subcapsular cataract following retinal detachment surgery. Here I demonstrate how to remove a thick epithelial layer from the posterior capsule and discuss anterior chamber depth in post-vitrectomized eyes.

An 80 yo Flomax patient with severe zonular laxity can present a number of challenges during cataract surgery. Here I demonstrate how the proper use of capsule retractors makes the case safer for the patient and easier for the surgeon.

When the goal is to implant a toric IOL in an eye with recurring bouts of uveitis, poster synechiae, an extremely shallow chamber and a previous iridectomy, a step-by-step approach is required. Here I demonstrate my approach including a pars plana vitrectomy to first deepen the anterior chamber.

After posting so many complicated cases, I thought it may be time to review my standard procedure with this one-eyed patient showing some slight macular degenerative changes. Leaving this patient myopic for better reading vision quality, my chopping technique, settings, and the benefits of vacuuming the posterior capsule are all discussed.

Endothelial protection is always important, though in a patient with severe corneal dystrophy and a shallow anterior chamber, it is even more critical. In this case, I discuss several pearls for safe removal of the nucleus in a patient with a severely compromised endothelium.

We start our 4th season with a very interesting case! My preoperative plan was to use a toric IOL in this 89 year old patient with a very dense cataract. After discovering a complete lack of zonular support, I perform a vitrectomy and change my lens choice to an AC IOL. I discuss control of the remaining astigmatism near the end of the procedure.