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First Author: Z.Mazhry PAKISTAN
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To evaluate the Reusable Aspheric Acrysof IQ and TECNIS Aspheric IOL metallic Injection systems in terms of ease of insertion, time spent and complications occurred during IOL loading and implantation in the capsular bag.
Eye Department Central Park Medical College &WAPDA Teaching Hospital Complex 210 Feroz Pur Road Lahore Pakistan.
Variety of Injection systems is available for fold-able IOL implantation during phaco cataract surgery. Loading and Injection Techniques differ from each other. Prospective study of 50 eyes each implanted with aspheric Alcon Arysof IQ and Abbot Tecnis Aspheric ZCB00 foldable IOLs from January 2011 to Dec 2012 was planned. Routine phacoemulsification was performed in all the eyes. Both types of IOLs were implanted using their own recommended cartridges and insertion devices provided by respective manufacturers i.e. disposable cartridge with reusable plunger in each group. Lens Insertion time (LIT) was calculated from opening of the IOL and its cartridge /injector to placement and final positioning of its haptics in the the capsular bag. Other criteria used to analyze, included; use of special instrumentation, optic haptic catch/damage, overshooting, use of excessive force during intraocular delivery, stress marks on IOL surface, and difficulty in unfolding etc.
All 50 eyes in each group had smooth Phaco and intra bag injection of IOLs with their recommended IOL Insertion System. LIT were ḟ100 seconds in AcrySof and ḟ95seconds in Tecnis group. Mild to moderate overshooting was noted in three cases in Tecnis group and none in AcrySof group. Special forceps was required in case of AcrySof to poaition the IOL in the cartridge. Excessive force was needed in case of Tecnis Aspheric. Loading of IOL consumed a little more time in case of AcrySof IQ group but the insertion process was much more controlled and smooth in Acry Sof IQ group as compared to Tecnis Aspheric group.
Both IOL Injection systems were found to be safe and effective. Placement and presentation of IOL in the cartridge in pre-injection position is of utmost importance. Limbs of the IOL (haptics) need to be folded on itself like a fetus in uterine cavity and it is to be placed low in the cartridge with the help of a forceps in case of AcrySof IQ and with regular capsule forceps in case of tecnis Aspheric.. Risk of haptic catch/cut and overshooting is minimized to almost nil if proper technique, explained in this presentation, is adopted.