I first saw Jack Chapman MD explain his technique to explant an IOL at a large ophthalmology meeting about 10 years ago. It was fascinating to me since it allowed the surgeon to remove a full-size IOL with a 6 mm optic via the same 2.75mm phaco incision through which it was inserted. Rahul Pandit MD from Houston, Texas, USA uses forceps with thinner arms and he can explant an IOL with this technique through a 2.2 mm incision.
We recently published this technique in the Journal of Cataract & Refractive Surgery (2020; 46:1072-1074). This technique can be used with any acrylic IOL, both single-piece and three-piece.
One important detail of the technique which is not easily seen in surgery videos is hand positioning. By starting with the hand supinated, it allows 300+ degrees of rotation to full roll the IOL optic prior to explanting it.
click below to learn this technique which you will find quite useful:
