Incision sizes at different stages of phacoemulsification with foldable intraocular lens implantation

Espiritu, Cesar Ramon G.; Bernardo, Juanchito P.

doi:10.1016/j.jcrs.2009.06.037

Cited by 16 publications

(10 citation statements)

References 41 publications

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“…In the present study, IOL insertion with D Monarch III and Unfolder Platinum cartridges widened the corneal incision by 0.13 mm in about 90% of patients with no significant differences emerging between devices. Our data concur with observations that, with diverse cartridge types, IOL implantation through a 2.2-mm clear corneal incision, was associated with incision enlargement in the majority of cases [6,14,15]. The ideal incision size was held to be 2.3 mm for the D cartridge with Monarch III with the wound assisted implantation technique, while 2.4 mm was believed to be the smallest incision the D cartridge tip could be fully inserted into [6,14,16].…”

Section: Discussionsupporting

confidence: 88%

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Corneal incision width after lens implantation: Comparing delivery systems

Cagini

Perri

Napoli

et al. 2018

Journal of EuCornea

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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.

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Section: Discussionsupporting

confidence: 88%

“…Older studies reported that keratome type, IOL type and dioptric power might affect incision width, but cartridge insertion undoubtedly may contribute to its enlargement [10,11,12]. More recently, maximum incision stretch was observed to occur during IOL implantation [13,14].…”

Section: Discussionmentioning

confidence: 99%

Corneal incision width after lens implantation: Comparing delivery systems

Cagini

Perri

Napoli

et al. 2018

Journal of EuCornea

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…10,11 Maximum incision stretch has been shown to occur during IOL implantation. 11 Steinert and Deacon 12 reported that an irreversible increase in incision size follows phacoemulsification surgery due to initial stretch-related incision tearing. Various factors have been seen to affect the amount of incision enlargement, including dioptric power of IOL, 13 type of IOL, 14 type of keratome, 15 and speed of IOL insertion.…”

Section: Discussionmentioning

confidence: 99%

Comparison of new motorized injector vs manual injector for implantation of foldable intraocular lenses on wound integrity: an ASOCT study

Khokhar¹,

Sharma²,

Patil³

et al. 2014

Eye

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Purpose To compare intraocular lens implantation using a motorized injector vs standard manual injector through a 2.2-mm clear corneal incision. Methods Patients underwent standard phacoemulsification using a 2.2-mm clear corneal incision. Hydrophobic acrylic aspheric intraocular lens (Acrysof SN60WF intraocular lens (IOL)) was inserted using D cartridge with manual monarch injector or autosert motorized injector. IOL safety, final incision size and wound integrity in terms of anterior and posterior wound gape, and descemet's membrane detachment were compared between the two groups at post-operative day 1 and at 1 month using Anterior Segment Optical Coherence Tomography. Results The study recruited 32 patients in the group I (manual injector) and 30 patients in group II (motorized injector). In group I, the final incision after IOL insertion increased by 0.12 mm (95% CI: 0.134-0.106) (Po0.0001), which was seen in 100% of the patients. In group II, the incision enlarged by 0.01 (95% CI: 0.021-0.0.001) (P ¼ 0.07) and was seen in only 6.67% of the cases. IOL nicks were seen in 9.37% of the cases in group I only. Although the incidence of descemet's membrane detachment and anterior wound gape was similar for both groups, posterior wound gape was seen more often with the manual injector in the immediate postoperative period. (P ¼ 0.018) Conclusion The motorized insertion system was gentle and safe for the IOLs with lesser incidence of IOL nicks. Regarding wound safety, it caused significantly less incision enlargement and better posterior wound integrity.

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“…Some extent of incision enlargement and stretch pertain to intraocular surgery, especially when IOL injector systems are used [6,7,13,[15][16][17]. Wound enlargement can occur at various steps of cataract surgery, but mostly during lens insertion procedures [18]. In our study, incision size enlargement by IOL insertion was seen with all injector devices, and the degree of enlargement differed significantly among groups.…”

Section: Discussionmentioning

confidence: 45%

Experimental Study on Delivery Performance of an Automated Preloaded Intraocular Lens Injector System for Corneal and Sclerocorneal Incisions

Oshika

Sasaki

2021

Journal of Ophthalmology

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Purpose. To evaluate delivery performance of an automated preloaded intraocular lens (IOL) injector systems (AutonoMe) in the porcine eyes. Methods. In the freshly excised porcine eyes, lens removal and IOL implantation were performed. There were 4 groups (10 eyes per group) with different incision site and size: 2.2-mm and 2.4-mm corneal incisions and 2.2-mm and 2.4-mm sclerocorneal incisions. Delivery performance and wound enlargement of AutonoMe were analyzed and compared with those of iTec and iSert from a previous study. Results. There were a few minor troubles associated with AutonoMe, such as overriding plunger within cartridge and trapped trailing haptic during IOL insertion, but the incidence was low. Other interactions were not observed, such as IOL adherence to plunger, sudden ejection of IOL, intrawound lens manipulation, IOL behavior, and gross damage to IOL. AutonoMe caused significantly less wound enlargement for both corneal and sclerocorneal incisions than other injector devices. Wound enlargement by using AutonoMe was significantly smaller with 2.4-mm corneal incision than with 2.2-mm corneal incision, but the final incision size was still smaller with 2.2-mm corneal incision. For sclerocorneal incisions, the amount of wound stretch was not different between 2.2 and 2.4 mm incisions. Conclusion. The wound enlargement caused by the automated preloaded insertion system, AutonoMe, was smaller than that of other preloaded injectors for both corneal and sclerocorneal incisions. There were a few minor technical events during IOL insertion, but the overall incidence was low.

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Incision sizes at different stages of phacoemulsification with foldable intraocular lens implantation

Abstract: Incision enlargement occurred at different stages of phacoemulsification, mostly during IOL implantation. More than 72% of eyes had a final incision of 2.3 mm. Beginning with a 2.3 mm incision may prevent wound tears and surface irregularities.

Cited by 16 publications

References 41 publications

Corneal incision width after lens implantation: Comparing delivery systems

Corneal incision width after lens implantation: Comparing delivery systems

Comparison of new motorized injector vs manual injector for implantation of foldable intraocular lenses on wound integrity: an ASOCT study

Experimental Study on Delivery Performance of an Automated Preloaded Intraocular Lens Injector System for Corneal and Sclerocorneal Incisions

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