Corneal incision width after lens implantation: Comparing delivery systems

Abstract

Purpose: to compare corneal incision width after phacoemulsification and intraocular lens implantation (IOL) using different delivery systems.Methods: one hundred and seventeen patients with cataract and no other anterior segment pathological features or previous eye surgery underwent cataract surgery with IOL implantation through a 2.2 mm incision. Three foldable IOL were implanted with their recommended delivery systems: Acrysof © SN60WF with Monarch © III/cartridge D (Group A, 38 patients); Tecnis © ZCB00 with Unfolder Platinum/cartridge easy load (Group B, 38 patients); Acrysof © SN60WF with Ultrasert TM preloaded system (Group C, 42 patients). Incision width was measured before and after phacoemulsification and IOL implantation.Results: Before and after phacoemulsification incision width was, respectively, 2.21 ± 0.02 mm and 2.34 ± 0.08 mm in group A; 2.20 ± 0.02 mm and 2.31 ± 0.06 mm in group B; 2.20 ± 0.02 mm and 2.30 ± 0.07 mm in group C. Incision width was not significantly enlarged after phacoemulsification. Before and after IOL implantation incision width was, respectively, 2.34 ± 0.07 mm and 2.47 ± 0.07 mm in group A; 2.32 ± 0.06 mm and 2.45 ± 0.08 mm in group B; 2.30 ± 0.07 mm and 2.39 ±0.07 mm in group C. Incision widths in group C were significantly different to groups A and B.No relationship was found between incision sizes and phacoemulsification time, ultrasound energy and IOL powers. Conclusion:In cataract surgery Ultrasert TM enlarges the corneal incision less than other delivery systems.

Experimental analysis of recommended corneal incision sizes in cataract surgery using 13 intraocular lens injector systems

“…With the introduction of foldable intraocular lenses, it was possible to develop intraocular lens injector systems that could facilitate surgery through mini-incisions (2.0–2.4 mm) and micro-incisions (< 2.0 mm). However, in most cases of mini- or micro-incision cataract surgery, the CCI becomes enlarged during surgery, leading to a bigger postoperative incision size 6 – 8 . These enlarged incision results are primarily assignable to the effects of insertion of the IOL injector systems into the incision 9 .…”