Official ESCRS | European Society of Cataract & Refractive Surgeons
Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Comparison of three different devices of implantation (Monarch III, Autosert and Ultrasert) in wound-assisted technique, in terms of complications during the implantation, incision enlargment and time spent to complete the in-the-bag implantation

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Session Details

Session Title: Cataract Surgery Equipment/Instrumentation/Surgical Devices I

Session Date/Time: Monday 12/09/2016 | 14:00-15:30

Paper Time: 14:50

Venue: Hall C5

First Author: : O.Moraru ROMANIA

Co Author(s): :    I. Iliescu                    

Abstract Details


Since cataract surgery is expected to deliver excellent refractive results, more refinements are done to ensure safety and reproducible outcomes. We decided to form three groups of eyes operated for cataract with implantation of the same posterior chamber intraocular lens (PC IOL) platform, done by the same surgeon, with the same wound assisted technique, but with 3 different implantation devices (Monarch III, Autosert and Ultrasert) and to compare them in terms of incision enlargement, time efficacy and complications. Incision enlargment and its impact on the surgical induced astigmatism is nowadays a major concern for every cataract surgeon.


Oculus Eye Clinic – Bucharest, Romania Author: Dr. Ozana Moraru Co-Author: Dr . Madalina Iliescu


This prospective randomized study comprises 300 eyes operated for cataract in 2016 with a 2.2/90* incision coaxial phacoemulsification. We measured the incision size before and at the end of implantation of an Acrysof PC IOL, in order to asses incision enlargement due to implantation. We measured the time spent to prepare the IOL(Time 1) and to implant the IOL in the capsular bag (Time2). We also noticed the difficulties during the implantation. We divided the 300 eyes into 3 groups (each of 100 eyes) according to the device of implantation (Monarch III, Autosert, Ultrasert) and compared the results between them.


In Monarch group, the medium incision enlargement was 0,14 mm (increase 6,35% than before the implantation), in Autosert group, it was 0,13 mm (6,07%) and in Ultrasert group, 0,18 mm (8,45%). The medium Time 1 and 2 in the first group was 32,22” and 17,90” respectively, in the second 34,98” and 15,75” and in the third group 30,39” and 20,30”. In the Monarch group in 9% of cases we experienced mild difficulties during implantation, in the Autosert group 6% and in the Ultrasert group in 24% (and only 16,25% after elimitating the first 20 cases, meaning the learning curve) .


After years of experience and excellent results with the implantation of the Acrysof lenses using the Monarch III Injector, nowadays we have two new posibilities of implanting these lenses: the Autosert and the latest preloaded system, Ultrasert. We concluded that Autosert is a very good tool with high safety profile, incision and time friendly and a very short learning curve. The Ultrasert, although it offers higher sterility safety due to its no-touch properties, seemed to produce the biggest incision enlargement in our hands and quite many difficulties when using it, which, however, decreased significantly after completing the learning curve.

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