About the Editor
About the Associate Editors
Foreword by David F. Chang, MD
Section I Preoperative Questions
Question 1 My Patient Has Dry Eyes and Blepharitis. How and When Do I Need to Treat These Conditions Before Cataract Surgery?
Preeya K. Gupta, MD
Question 2 My Patient Has Unreliable Topography Due to Ocular Surface Pathology. What Are My Options for Treatment and Intraocular Lens Selection?
Deepinder K. Dhaliwal, MD, LAc and Mojgan Hassanlou, MD, FRCSC
Question 3 When and How Should Cataract Surgery Alone Be Performed in Patients With
David T. Vroman, MD and Kristiana D. Neff, MD
Question 4 My Patient Has a Cataract and Glaucoma. Which Patients Need a Combined Glaucoma Procedure, and Which Device(s) Should I Use?
Thomas Samuelson, MD
Question 5 What Should I Do Differently in Patients at High Risk for Retinal Complications?
Steve Charles, MD, FACS, FICS and Eric J. Sigler, MD
Question 6 What is Spherical Aberration, and How Do I Know When to Put in a Positive, Negative, or Neutral Spherical Aberration Intraocular Lens?
Farrell C. Tyson, MD, FACS
Question 7 My Patient Wants Enhanced Depth of Focus and Spectacle Independence. How Should I Decide Between Monovision or a Presbyopia-Correcting Intraocular Lens?
Sumitra Khandelwal, MD; David R. Hardten, MD; and Richard L. Lindstrom, MD
Question 8 How Do I Pick the Right Intraocular Lens Formula for My Patient With a Longer or
Shorter Than Average Eye?
Robin R. Vann, MD
Question 9 How Do I Address Intraocular Lens Calculations and Selections in the Postkeratorefractive Patient?
Warren E. Hill, MD, FACS
Question 10 My Cataract Patient Has a Pterygium in the Operative Eye. How Do I Know if it Has an Impact on My Intraocular Lens Calculations? If So, What Should I Do?
Mahshad Darvish, MD and Edward Holland, MD
Question 11 When Should I Use a Toric Intraocular Lens Versus Astigmatic Keratotomy or Peripheral Corneal-Relaxing Incisions?
Eric C. Amesbury, MD and Kevin M. Miller, MD
Question 12 My Astigmatic Keratotomy Results Are Unpredictable. How Can I Improve Them?
R. Bruce Wallace III, MD
Question 13 My Patients Have Irregular Astigmatism. Are They Still Candidates for a Toric Intraocular Lens or Limbal-Relaxing Incisions? If Not, What Are My Options?
Parag Majmudar, MD and Fred Chu, MD
Question 14 I Have a Cataract Patient With a Traumatic Iris Defect and Glare Symptoms.
What Should I Do?
Michael E. Snyder, MD and Mauricio A. Perez, MD
Question 15 With How Large a Zonular Dialysis Can Phacoemulsification Be Performed?
Bonnie An Henderson, MD
Question 16 When and How Should I Consider a Nonphacoemulsification Technique to Remove a Cataract?
Geoffrey C. Tabin, MA, MD; Dipanjal Dey, MD; and Benjamin Thomas, MD
Question 17 How Do I Incorporate Femtosecond Laser Into My Current Cataract Surgery
Richard Tipperman, MD
Section II Intraoperative Questions
Question 18 How Do I Move From a Larger to a Smaller Phaco Incision?
Paul Ernest, MD
Question 19 Under Topical Anesthesia, the Patient Is Uncooperative and Complaining of Pain. What Should I Do?
Scott Greenbaum, MD
Question 20 What Is the Best Way to Manage Intraoperative Floppy Iris Syndrome?
David F. Chang, MD
Question 21 My Patient Has a Small Pupil. What Are My Options for Expansion?
Boris Malyugin, MD, PhD
Question 22 What Should I Do if the Chamber Is so Shallow That it Does Not Deepen Much With Viscoelastic?
Lisa Brothers Arbisser, MD
Question 23 My Capsulorrhexis Is Heading Out Peripherally. How Should I Proceed, and What Should I Do if it Tears Radially?
Brian Little, MA, DO, FHEA, FRCS, FRCOphth
Question 24 Following Hydrodissection, the Iris Is Prolapsing and the Globe Is Very Firm. How Should I Proceed?
Mark Packer, MD, FACS, CPI
Question 25 Despite Attempting Hydrodissection, I Cannot Rotate the Nucleus. How Should I
William J. Fishkind, MD, FACS
Question 26 I Usually Perform Divide-and-Conquer Phacoemulsification. How Can I Incorporate Chopping Into My Technique?
Randall J. Olson, MD
Question 27 After Chopping or Cracking a 4+ Nucleus, a Leathery Posterior Plate Still Connects the Fragments Centrally. How Should I Proceed?
Roger F. Steinert, MD
Question 28 How and When Should I Change My Phaco and Fluidics Settings in the Following Situations: Intraoperative Floppy Iris Syndrome, Shallow Chamber, High Axial Length, Postvitrectomy?
Barry Seibel, MD
Question 29 How Do I Recognize and React to a Posterior Capsular Rupture?
Rosa Braga-Mele, MD, MEd, FRCSC and Theodore J. Christakis, MD
Question 30 The Anterior Capsule Has a Radial Tear. How Do I Proceed With Phaco and Intraocular Lens Implantation?
Christina S. Moon, MD and Sonia H. Yoo, MD
Question 31 When and How Should I Implant an Intraocular Lens in the Ciliary Sulcus?
Thomas A. Oetting, MS, MD
Question 32 The Capsular Bag Is Unexpectedly Mobile During Phaco. When Should I Implant a Capsular Tension Ring, and Which Size Should I Use?
Iqbal Ike K. Ahmed, MD, FRCSC
Question 33 When Should an Anterior Vitrectomy Be Performed via the Pars Plana Versus the
Louis D. "Skip" Nichamin, MD
Question 34 If I Cannot Put the Lens in the Bag or the Sulcus, How Do I Approach Scleral Fixation of an Intraocular Lens?
Richard S. Hoffman, MD
Question 35 When and How Do I Insert an Anterior Chamber Intraocular Lens?
Derek W. DelMonte, MD
Question 36 How Do I Proceed if I See a Small Wound Burn With Whitening of Corneal Stroma? How Would I Close a Severe Corneal Burn?
Robert H. Osher, MD
Question 37 How Should I Manage a Small or Large Descemet’s Membrane Detachment That Occurs During Cataract Surgery?
Terry Kim, MD
Question 38 What Should I Do Differently With a Posterior Polar Cataract?
Robert J. Cionni, MD
Question 39 What Should I Do Differently With a Hypermature White Cataract?
Uday Devgan, MD
Section III Postoperative Questions
Question 40 How Long Should Topical Antibiotics and Nonsteroidal Anti-Inflammatory Drugs Be Used Before and After Cataract Surgery?
Francis S. Mah, MD
Question 41 What is Causing Low or High Intraocular Pressure in My Postoperative Patient?
Richard A. Lewis, MD
Question 42 Following Uneventful Surgery, Three of My Eight Patients Have 4+ Cell and Fibrin on Postoperative Day 1. What Should I Do?
Nick Mamalis, MD
Question 43 How Do I Manage High-Risk Uveitis Patients Preoperatively and Postoperatively?
Michael B. Raizman, MD
Question 44 The Lens Has Dropped. How Should I Manage It, and When Should I Refer the Patient to a Retina Specialist?
Keith A. Warren, MD
Question 45 How Should I Manage a Postoperative Refractive Surprise?
Stephen S. Lane, MD
Question 46 What Causes My Patients to Complain About Temporal Shadows or Reflections, and How Should I Manage Persistent Symptoms?
Samuel Masket, MD and Nicole R. Fram, MD
Question 47 What Should I Do With the Unhappy Patient After Implantation of a Presbyopia-Correcting Intraocular Lens in One Eye? After Implantation in Two Eyes?
William Trattler, MD and Gaston O. Lacayo III, MD
Question 48 Following a Posterior Capsular Rent, the Sulcus-Fixated Intraocular Lens Has Become Decentered. How Should I Proceed?
Garry P. Condon, MD
Question 49 My Pseudoexfoliation Patient Has Newly Discovered Pseudophacodonesis 5 Years Following Surgery. How Should I Proceed?
Alan S. Crandall, MD