IOL exchange: Technique and surgical pearls

IOL implantation requires proper seating of the IOL within the lens capsular bag, with good IOL centration and without any contact with the adjacent tissues such as the iris. Repeated mechanical rubbing of the IOL against the iris tissue can result in secondary inflammation such as iritis, synechiae formation, pupillary distortion, secondary glaucoma and even macular edema with decreased postoperative vision. The indications for an IOL exchange include: Incorrect IOL power calculations preoperatively. Optical aberrations interfering with the patient’s daily activities. Subluxated and dislocated IOL. IOL opacification causing visual symptoms. Damaged IOL with ongoing secondary adjacent tissue damage and/or visual symptoms.In this column, I describe the surgical technique of IOL exchange in a referred patient, with IOL optic damage during surgery, and present some surgical pearls for IOL exchange.