LAUSR

because of the risk for iris chafing and subsequent IOP rise. I also have doubts about the stability of the toric IOL when prolapsing the optic out of the bag. Because of the concomitant cyanopic dyschromatopsia, implantation of a clear supplementary IOL would not resolve the chromatopsia problem. Therefore, my preferred approach would be IOL exchange and reverse optic capture with a 3-piece yellow-colored (blue-filtering) IOL (eg, MN60AC, Alcon Laboratories, Inc.). I recently exchanged a Tecnis toric IOL, and this is feasible when applying careful counterforce to the zonular apparatus when releasing the haptic endings from the capsular bag adhesions. If explantation is technically not feasible, I would amputate the optic from the haptics and leave the haptics in place. Subsequently, I would place the 3-piece yellow-colored blue-filtering IOL in the sulcus. I would treat the 2.0 D of ATR corneal astigmatism with femtosecond laser arcuate keratotomies and explain to the patient that there might be some residual astigmatism postoperatively.