In situ tumbling of the AcrySof intraocular lens

The small incision through which foldable acrylic intraocular lenses (IOLs) are implanted does not allow easy explantation of the lens in the event of intraoperative complications. Reversal of the IOL optic during insertion, although rare, can predispose to postoperative complications such as pupillary capture of the IOL, capsule bag distension syndrome, and refractive problems. Explanting the IOL can damage it, the cataract wound, or both. We describe a technique of in situ tumbling of the AcrySof IOL to correct reversed-optic implantation that preserves the integrity of the IOL and anterior segment structures.