Incision Dynamics And Surgical Efficiency Using Two Versions Of A Preloaded Iol Injector. A Comparative Study.

To compare corneal incision behavior and intraoperative efficiency between two versions of a preloaded intraocular lens (IOL) injector, pioli™ and pioli™ Plus (AST VisionCare, Inc), during cataract surgery with implantation of a monofocal IOL.

Oftalvist clinics in Sevilla and Alicante, Spain

This prospective observational study included eyes undergoing routine phacoemulsification with implantation of the Asqelio™ monofocal IOL using either the pioli or pioli Plus preloaded injector. Corneal incision size was measured intraoperatively at three time points: initial incision, post-phacoemulsification, and post-IOL insertion. Surgical efficiency was assessed by recording injector-related times: device-in-eye contact time (T1), rear-haptic release time (T2), complete IOL deployment time (T3), and total surgeon IOL time (TLIO). Adverse events and intraoperative deviations were documented.

Forty-two eyes were analyzed (22 pioli; 20 pioli Plus) with comparable baseline characteristics. Both injectors maintained excellent incision stability, with minimal enlargement after IOL implantation (0.08 ± 0.04 mm for pioli and 0.06 ± 0.02 mm for pioli Plus), without clinically relevant differences in total incision change (p>0.05). pioli Plus rD demonstrated significantly greater surgical efficiency, with shorter times across all injection phases. Total surgeon IOL time (TLIO) was reduced by approximately 23 seconds with Pioli Plus compared with Pioli (41.72±7.79 s vs 65.24±10.66 s; p<0.001), representing a 36% reduction. No adverse events occurred.