Comparison of two techniques for toric intraocular lens implantation: hydroimplantation versus ophthalmic viscosurgical devices

Abstract

Background: To compare the results between hydroimplantation of a single-piece, acrylic foldable toric intraocular lens (IOLs) and conventional implantation using an ophthalmic viscosurgical device (OVD). Methods: In this study, 60 eyes with cataract and preexisting regular corneal astigmatism of 1.0 to 3.0 diopters (D) underwent the implantation of the AcrySof toric IOLs (Alcon Laboratories, Inc.). The patients were randomly assigned to a conventional implantation technique with an OVD or a hydroimplantation technique. Comparison of preoperative and postoperative parameters was performed using paired Student t tests, and independent Student t test was used to compare between the two groups. Results: Three months postoperatively, the mean subjective astigmatism was 0.45 D ± 0.24 (SD) in the OVD group and 0.49 ± 0.29 D in the hydroimplantation group (P = 0.492). The mean endothelial cell density (ECD) loss was 7.54% ± 0. 82% and 7.32% ± 0.59%, respectively (P = 0.117). The mean absolute IOL rotation was 4.77 ± 2.32 degrees and 4.70 ± 1. 95 degrees, respectively (P = 0.334). The mean time for IOL implantation was 71.50 ± 8.10 s and 37.60 ± 3.90 s, respectively (P < 0.001). Two hours, 1 day, 1 week, 1 month, and 3 months postoperatively, there was no significant difference in IOP between the two groups (P > 0.05), although IOP two hours postoperatively seemed to be a little higher in the OVD group. Conclusions: Compared with the use of OVDs for toric IOLs implantation, the hydroimplantation technique provided advantages of increased efficiency, reduced surgical time and cost, and no concerns of OVD-induced elevated IOP.

Comment on: Comparison of the clinical outcomes of Eyecryl™ and Tecnis® toric intraocular lenses: A real-world study

“…[ 2 ] The importance of behind the IOL OVD removal and early postoperative IOP spike has not been discussed. [ 3 ]…”

A novel ophthalmic viscosurgical device-free phakic intraocular lens implantation makes myopic surgery safer

“…The hydroimplantation technique first introduced in 2010 by Tak [25] uses an irrigation cannula for intraocular lens (IOL) implantation in the aphakic eye after phacoemulsification. Its efficacy and safety has been evaluated in randomized controlled trials for IOL (including toric IOL) implantation [26,27] and both studies found that this technique is safe and effective with reduced surgical time and cost when compared to the conventional implantation using OVDs. To the best of our knowledge, this OVD-free method introduced in our study is the first reported patented method specific for posterior chamber phakic IOL implantation.…”

Hydroimplantation versus viscoimplantation: comparison of intraocular lens implantation with and without ophthalmic viscoelastic device in phacoemulsification

“…Ogurel et al reported that reduced time is approximately three minutes [6]. A recent study by Chen et al compared the hydroimplantation technique with the conventional implantation on toric intraocular lens and concluded that the hydroimplantation technique provided advantages of increased efficiency, reduced surgical time and cost, and no concerns of OVDinduced elevated IOP [11].…”