Surgical Roundtable Case 3: Fixing a Tilted Secondary IOL

Christina Weng, MD, MBA, presents a case of secondary IOL tilt correction, highlighting a novel 5-point scaffold technique for lens stabilization, and a panel of expert vitreoretinal surgeons discusses rescue strategies, IOL exchange vs preservation, and pearls for managing postoperative lens tilt.

By
Christina Y. Weng, MD, MBA
Mrinali Gupta, MD, FASRS
Nimesh A. Patel, MD
Frank Brodie, MD, MBA
July 1, 2026
16 min

Retinal Physician

Background

Tilted secondary IOLs can significantly affect visual outcomes and are often a result of capsular or zonular instability. The development of new techniques, such as the 5-point scaffold, reflects ongoing efforts to refine surgical approaches in this area.

Data Highlights

No numerical data or trial data was provided in the source material.

Key Findings

The 5-point scaffold technique can effectively correct tilt in secondary IOLs.
Dr. Weng prefers the modified Yamane technique for its simplicity and efficiency.
Tilt of IOLs, including the CT Lucia 602, has been reported and can lead to visual disturbances.
Surgeons emphasize the importance of judgment and technique selection in secondary IOL surgeries.
Innovations like the prosthetic capsular bag may offer new possibilities for IOL fixation.

Clinical Implications

Surgeons should consider various fixation techniques for optimizing surgical outcomes.

Conclusion

The introduction of the 5-point scaffold technique represents a significant advancement in the management of tilted secondary IOLs, highlighting the need for continuous innovation in surgical practices.