Our guest surgeon is Jeff Whitman MD from Dallas, Texas, USA who shows us his technique for IOL exchange. While my preferred technique is the twist-and-out method to remove an acrylic IOL (6mm optic) via a 2.75 mm incision, another option is to cut the IOL into halves and then pull these straight out. Note that the optic is cut about 90% through but a small zone of attachment is left. This allows the first half to help pull the second half out of the eye. Another great pearl is to place the new IOL in the capsular bag while the old IOL is up in the anterior chamber. This scaffold technique allows the optic of the new IOL to protect the posterior capsule from the scissor tips.
click to learn how to cut the IOL for exchange using the scaffold technique: