Preloaded Injectors for IOL Implantation: Rotational Versus Injective System
Narrative Responses:
Purpose
To compare two different IOL injection methods (rotational Vs injective metal injectors) with their evolution (preloaded single use plastic injectors) to implant single piece Acrylic IOLs after phacoemulsification.
Methods
We evaluated four groups: A- Emerald Abbott Injector to implant Tecnis ZCB00 (metal, rotational). B- Preloaded Tecnis IOL injector (plastic, rotational). C- Monarch Injector for Alcon Acrysof IQ Aspheric IOL (metal, injective). D- Preloaded Alcon IOL injector (plastic, injective). 80 implants, 20 each group, same surgeon, uneventful 2.75 phaco surgery. Three steps were considered: 1- loading phase. 2- injection phase. 3- unfoalding and conditions of the IOL.
Results
Phase 1, groups A and C (metal injectors) performed worse than respective preloaded plastic injectors (groups B and D). Phase 2 smoothness and control were higher in groups A and C (metal). The injective device in our hands performed better because it’s single hand controlled system. Phase 3 was better in groups A and C, the surgeon is able to control each single step during the positioning of the IOL into the cartridge, thus resulting in a higher reproducibility of the unfoalding phase of the IOL. Small damages and scratches to the IOL were higher in groups B and D.
Conclusion
Preloaded systems are safer and easier. Less can be done by the surgeon to control the foalding phase of the IOL. In our hands the injective device performed better, surgeon’s second hand is free. Smoothness and precision of the plastic injectors is, unfortunately, not yet comparable to the metal ones.