3031: safely remove this dislocated IOL
When an intraocular lens dislocates into the posterior segment and comes to rest directly on the macula, a meticulous surgical approach is required to prevent retinal damage. The first critical step is performing a full core and peripheral pars plana vitrectomy to thoroughly relieve all vitreous traction and completely liberate the dislodged optic and haptics. Once freed from vitreous attachments, the IOL can be safely grasped with vitreoretinal forceps, elevated into the anterior chamber, and explanted. Reconstruction is then achieved by implanting a new three-piece IOL using the Yamane intrascleral haptic fixation (ISHF) technique, ensuring precise centration and secure, sutureless long-term stability without capsular support. Watch the video to see this step-by-step vitreoretinal and anterior segment recovery strategy. What is your preferred technique or instrument set for safely elevating a dislocated IOL off the macular surface? Please comment your pearls below.
