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Remove Marred IOL

Here is a case where we injected the IOL and noticed a central mar. I have noticed mars on the SNWFs at times after injecting them especially it seems when using viscoat rather than ocucoat in the monarch injector. In this case, the mar in the IOL was central and I thought it may cause some visual issues. As such, I decided to remove the IOL. There are a bunch of ways to remove an IOL. You can cut it as we did in this case. You can cut it halfway as we did in the Pac Man movie on this link: http://www.facebook.com/cataract.surg... You can cut the IOL completely in half and bring out both halves, or you can cut almost all the way through as in this case and then bring it out. I like the Osher mildly serrated cutter from Duckworth and Kent as shown in this video. Another option is to refold the IOL in the eye. I show this technique in a video on the link below. Refolding the IOL only works with thin acrylic IOLs like the SNWF, SA60, MA60 but is very tricky with thick acrylic IOLs like the AR40 and nearly impossible with the slippery IOLs like the silcon three-piece IOLs. Refolding requires a slightly larger incision (for the forcep) and an extra paracentesis across from the main wound. http://www.facebook.com/cataract.surg... It is hard to know what to do with the little mars that we see in IOLs. Usually they seem to cause no trouble. If I had noticed this mar at the slit lamp after the case I probably would have simply notified the patient and waited to see how they did before exchanging it. I think you should always mention these issues to the patient as they will eventually find out and it is best coming from you. I usually tell them "that there is a small mar in the IOL and that usually, they cause no trouble. if it does we can easily exchange the IOL"