3000: celebration & how I perform an IOL exchange
Celebrating Video 3000
This milestone marks a major achievement for CataractCoach.com, celebrating the publication of our 3000th educational video. Thank you to the global ophthalmology community for your incredible support and dedication to surgical education over the past eight-plus years.
To mark this occasion, this combination video features a complete, step-by-step masterclass demonstrating the precise surgical technique for performing an intraocular lens exchange.
Step-by-Step IOL Exchange Technique
Performing an IOL exchange requires a highly deliberate approach to protect the capsular bag and zonular apparatus. The procedure highlights several vital surgical pillars:
- Freeing the Haptics: Viscodissection is used to gently open the capsular bag equator and free the haptics from fibrotic adhesions without causing zonular stress.
- Prolapsing the Optic: Once fully mobilized, the lens is carefully brought out of the capsular bag and into the anterior chamber.
- Twist-and-Out to explant the Lens: Using the twist-and-out technique, we can easily explant the lens to allow for safe removal through a small incision.
- Implanting the new IOL: After the old lens is removed, a new IOL is delivered into the preserved capsular bag.
Thank you all for the support to achieve this 3000th milestone!
Most of the cases I get referred have been in the eye for years and are socked in. There are techniques for safely removing fibrosed in haptics. Please be aware that lenses that have been in the eye for a while don’t just slide out and can be a challenge to remove safely (but it CAN be done). Also this twist and pull technique will work for some lenses but not others….i.e. not good for J&J SPA IMO and also 3 piece lenses. I usually cut and remove in 2 pieces. Removing a lot of LAL’s now and those get cut into 3 pieces (or more)