IOL Exchange from Sight Savers
Preferable with 2 weeks
Dilate well
Make sure there is no synechae
Take the visco cannula and move the tip all around 270 degrees
At the rhexis margin by injecting visco
Slowly the bag separates from the IOL
Then try to dial IOL only 5 degrees to see whether it is free
If not, inject visco again
This time go bit deep in the bag and inject
Hydrophilic IOL comes out easily
Either extend the corneal wound or
Make a small sclera-corneal tunnel
May need a suture
Hydrophobic IOL needs to be cut
Tends to stick to the capsule very early
Through and through not needed
Half optic needs to be cut
Can be cut with Vannus
Remove one half first
Take endothelial reading before doing it
If count less than 1700 or so, better to do sclero-corneal tunnel
Otherwise remove through corneal tunnel
Pull and Cut technique.
Prolapse one haptic into AC.
Grasp and pull through tunnel.
Cut IOL with Vanuus through and through.
