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Intraocular lens delivery characateristics of the preloaded AcrySof IQ SN60WS / AcrySert injectable lens system

Poster Details

First Author: H.Ong UK

Co Author(s):    M. Subash   A. Sandhu   M. Wilkins        

Abstract Details



Purpose:

With continual advances in cataract surgery, development of safe, effective and predictable mechanisms of intraocular lens (IOL) delivery through increasingly smaller incisions remains a constant goal. The purpose of this study is to evaluate the delivery characteristics of the AcrySof IQ SN60WS IOL injected via the preloaded AcrySert delivery system.

Setting:

This study was carried out in the cataract service of Moorfields Eye Hospital, which serves a large sector of inner city London - the host city of ESCRS 2014.

Methods:

This was a prospective observational case series. The study included all patients undergoing routine phacoemulsification with implantation of the SN60WS IOL via the preloaded system over five consecutive months. A total 85 patients (85 eyes) were included in this study. Phacoemulsification procedures conducted by seven surgeons were digitally captured on video. Video recordings of the IOL delivery stage were analyzed by a single observer. Of particular interest were the orientation of the leading haptic and optic on insertion, the degree of intra-wound manipulation of the injector and time required to satisfactorily deliver the IOL into the capsular bag in a correct orientation. Problems of IOL delivery were also noted.

Results:

In 38 out of 85 (45%) eyes, correct IOL delivery behaviour was achieved with the leading haptic orientating to the left of the surgeon and thus did not require any intrawound rotational manipulation of the injector. Forty-seven of the 85 eyes (55%) required additional rotational manipulation of IOL orientation. Other problems recorded were trapped trailing haptic, haptic-optic adhesion, overriding of the plunger over the optic, and trauma to optic edge. The average time to achieve satisfactory IOL position was 47seconds. IOL power and the grade of the operating surgeon did not appear to influence the event of a misdirected leading haptic.

Conclusions:

The AcrySof SN60WS/AcrySert system does not currently appear to provide a fool-proof and predictable means of IOL delivery. This data may assist surgeons in their choice of lens and encourage adequate training and due caution when implanting the SN60WS with AcrySert system for the first time. FINANCIAL INTEREST: NONE

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