Vitreoretinal surgeons often have to deal with dislocated intraocular lenses. Aside from mobilizing a dislocated lens into the anterior chamber, vitreoretinal surgeons also have to be able to efficiently remove the lens from the eye. There are a number of techniques to accomplish this including cutting the lens in half and removing it through a clear corneal wound or cutting the optic 3/4 of the way and rotating the lens out through a clear corneal wound (the so-called “pac-man” technique). Here we demonstrate the “twist and out” IOL removal technique first described by Drs. Pandit, Devgan and Chapman. The benefit of this technique is that it is efficient and does not require any special instruments such as lens-cutting scissors or lens-grasping forceps. The lens is mobilized into the anterior chamber with a haptic externalized through the corneal wound. The edge of the optic is then grasped with a McPherson forceps and with the assistance of a spatula the lens is twisted and folded to a smaller dimension so that it can be removed through a clear corneal wound. This case, contributed by Dr. Thada Tantisararsart from Thailand, is combined with a full pars plana vitrectomy in a patient with history of CMV retinitis. Thank you Dr. Tantisararsart for contributing this case!
