Comparative assessment of the corneal incision enlargement of four preloaded intraocular lens delivery systems
First Author: T.Kohnen GERMANY
To comparatively evaluate the corneal incision enlargement and incision structure of AutonoMe, a new automated preloaded delivery system, to UltraSert, TECNIS iTec (iTec) and HOYA Vivinex™ iSert® (Vivinex) preloaded delivery systems.
Alcon Vision LLC, Fort Worth, TX, USA; Design: Experimental study
Sixteen (16) preloaded IOLs (20.0 D-21.0 D) per treatment group were delivered into the anterior chamber of human cadaver eyes through a 2.0 mm (Vivinex) or 2.2 mm (AutonoMe, UltraSert, and iTec) incision size. Corneal incision morphology was evaluated using optical coherence tomography (OCT) and incision sizes were measured using ASICO incision gauges before and after IOL delivery. Differences in mean incision enlargement between delivery devices were evaluated using a paired t-test.
AutonoMe (0.29±0.03 mm) and UltraSert (0.29±0.03 mm) had the smallest average incision enlargement compared with iTec (0.31±0.03 mm) and Vivinex (0.36±0.06 mm). Vivinex had the largest corneal incision enlargement and was significantly larger than AutonoMe (p=0.001), UltraSert (p=0.001) and iTec (p=0.002). Representative OCT images of pre- and post-implantation incisions (cross sectional images of cornea) showed more incision gaping, corneal stromal damage and distortion for delivery systems with the largest incision enlargement: Vivinex and iTec.
The new AutonoMe preloaded delivery system protects the corneal incision during IOL implantation and causes smaller incision enlargement and less corneal stromal damage compared to iTec and Vivinex. Further clinical studies are necessary to confirm the effect of incision enlargement on wound healing and post-operative corneal morphology.