In order to perform cataract surgery upon this non-English speaking patient, I first have to remove an iris-fixated anterior chamber lens implanted 11 years previous. This case highlights removal of the phakic IOL, the value of a translator during surgery and the use of intraoperative aberrometry to determine the correct IOL power.

This case demonstrates the use of intraoperative aberrometry plus the Aphakic Refraction Technique to best determine the final IOL power in a keratoconic eye. Tips for visualization, a comparison of phaco chop and divide and conquer and the advantages of a high IOP setting round out this very educational case.

Patience is a critically important trait for all surgeons to develop and maintain. In this patient, Dr Mackool demonstrates its value during removal of a red/brunescent cataract in a one-eyed patient.

In response to viewer requests, this video demonstrates the Divide and Conquer procedure using a curved ultrasonic needle (Balanced Tip). A useful method of eyelash isolation is also shown.