Because unstable intraocular lenses (IOLs) can frequently present as posterior segment surgical problems rather than simply as isolated cataract issues, secondary IOL surgery has become an important tool in the retina specialist's armamentarium. However, there is no “one-size-fits-all” approach for replacing an intraocular lens that's dislocated.

In this video, Ajay Kuriyan, MD, recounts the main points attendees learned from his instruction course, “Secondary IOL Techniques for Retinal Specialists,” at the American Academy of Ophthalmology (AAO) 2026 Meeting in New Orleans, as well as the various techniques he and his colleagues discussed when removing and replacing IOLs.

The following transcript has been edited for clarity.

Hello, I'm Ajay Kuriyan from Wills Eye Hospital. I'm excited to talk about the course that we just presented on secondary intraocular lens placement. This course was designed for people of varying different skill levels to go over all the different options that are out there right now for secondary IOL placement. I'd like to thank my other faculty who were there for the course, including Omesh Gupta, MD; Mohammed Ali Khan, MD, FACS; Ella Leung, MD; and Meera Sivalingam, MD, for all their input into the course. And they really helped make this course a very comprehensive overview for all different options for secondary interval IOLs. 

This course was designed for people of various different training stages to provide an overview of different ways to place secondary intraocular lenses. Many of these techniques have become a lot more popular over the last few years, and so some people have just not been exposed to these techniques during their training. We felt that a course like this would provide a good overview of different techniques, as well as exposure to different tips and tricks from some of the experts for these IOLs.

We started off the course with talking about how to remove dislocated IOLs, whether it's just prolapsing into the anterior chamber from behind the iris or removing it from the vitreous cavity into the anterior chamber. We provided some tips and tricks for those procedures, as well as the importance of maintaining a small corneal wound to limit corneal astigmatism when you're removing these lenses.

We then shifted gears to talk about different secondary IOL placement techniques, including anterior chamber IOLs, which are still a great option for the right patient, as well as different fixated IOL techniques, including iris fixated lenses, scleral fixated lenses using either the Yamane technique or the trocar-based technique, as well as sutured lenses using the Gore-Tex suture utilizing the MX60 or the AO60 lenses.

These techniques all have different pros and cons, and patient selection is key for all of them. So we reviewed different things to think about when you're approaching a patient to try to figure out the best possible lens for them.

We also offered the opportunity for different participants to ask questions from some of these experts about ways that they specifically do these techniques and things they learned along the way.

Overall, I thought one of the main take-home points from the course is that there's no one best way to fix an IOL that's dislocated. There's a lot of different options, and taking into account the patient's ocular health, other surgeries, and conjunctival health are all important factors when deciding the best intraocular lens placement option for these patients. Thank you.