Comparison of Incision Integrity and Morphological Features After IOL Implantation With 3 Injector Devices: Randomized Clinical Trial
Narrative Responses:
Purpose
Evaluate and compare incision enlargement as well as ingress of trypan blue from the ocular surface into the anterior chamber following implantation of a foldable hydrophobic acrylic intraocular lens (IOL) through a 2.2 mm clear corneal incision (CCI) using one automated and two manual injector systems.
Methods
Randomized clinical trial in120 eyes (120 patients) undergoing microcoaxial phacoemulsification through a 2.2mm CCI randomized to three groups depending on IOL injector used: Group I(n=40), where automated motorized injector (Autosert) used; Group II(n=40), where a plunger type injector (Royale) used; Group III(n=40), screw type injector (Monarch III) used. Incision widths were measured before and after implantation of a foldable, single-piece aspheric hydrophobic acrylic IOL using D cartridge. Following IOL implantation and stromal hydration, trypan blue 0.0125% was applied over the conjunctival surface, and ingress compared.Architectural features of CCIs were evaluated using anterior segment OCT(AS-OCT) on postoperative day1, 1week, and 1month.
Results
Ongoing study,results of 60 eyes presented,results will be updated.Incision enlargement from end of phacoemulsification to IOL implantation: Group I (n=19): 0.07+0.05, Group II (n=18): 0.16+0.05, Group III (23): 0.22+0.04; difference being statistically significant (P=0.03). Incision enlargement was greatest with Monarch III injector, followed by Royale,and Autosert. Trypan blue concentration into anterior chamber was (log units): GroupI=1.97+0.45, Group II=1.78+0.48, Group III=2.16+0.38; difference not statistically significant (P=0.48). No difference in descemet’s detachment, incision gaping and loss of coaptation between groups at any follow-up (P>0.05).
Conclusion
All injectors allowed smooth IOL implantation through a 2.2mm incision. However, incision enlargement and trypan blue ingress from the extraocular surface into the anterior chamber was least using automated injector