The Glass Rod Technique: A New Method For Safe Removal Of Soemmering's Ring Fragments After Iol Explantation

To describe the Glass Rod Technique for controlled, traction-sparing removal of rigid, calcified Soemmering’s ring remnants during IOL explantation when extraction with a vitrector or forceps is ineffective and posterior migration is a concern. 

Department of Ophthalmology and Optometry, St. John’s Hospital, — Vienna, Austria. 

Sigmund Freud Medical University, — Vienna, Austria. 

We included five cases of IOL explantation for late IOL subluxation/dislocation. Inclusion criteria were rigid retained Soemmering’s ring fragments after IOL removal that could not be removed with the vitrector (neither aspirated nor cut) or with forceps. 
The technique combines a pars plana infusion port to establish a posterior-to-anterior fluid current with a hollow glass extraction tube introduced through the main incision (Geuder DMEK implantation cartridge). After targeted vitrectomy of vitreolenticular adhesions, the fluid current guides fragments into the tube's lumen, allowing extraction. 

In all five cases, calcified fragments that could neither be aspirated/cut, nor extracted, were removed completely. No fragment migrated posteriorly. Removal was traction-free, and no intraoperative complications occurred. 

Rigid, calcified Soemmering’s ring remnants are a common and frustrating problem during IOL explantation. Incomplete control can lead to posterior loss. Additionally, forceps maneuvers pose traction risk if adhesions are present. In this case series, the Glass Rod Technique provided a simple, reproducible way to remove such fragments in a controlled manner using readily available instrumentation. It represents a practical bailout when the vitrector and forceps are ineffective or when posterior loss is of concern.