Assessment of Wound Enlargement Using Human Cadaver Eye Model During Manual and Automated IOL Delivery

Sunday, April 19, 2015: 4:12 PM
Room 5B (San Diego Convention Center)
Lixin Wang, MD, PhD
Patricia Wolfe, PhD
James S. Marotta, PhD
Khiun F. Tjia, MD
Thomas Kohnen, MD, PhD
Sumit Paliwal, PhD

This study assessed corneal wound enlargement using a human cadaver eye model, with manual and automated delivery of a hydrophobic IOL (AcrySof IQ 27.0 ± 0.5 D, Alcon). Results obtained using this model are compared to previously reported clinical findings.

Human cadaver phakic whole eye globes were used in this study.  There were 2 groups (n=6 eyes/group). Each pair of human cadaver eyes was randomly assigned to manual (Monarch III handpiece with Monarch D cartridge, Alcon) or automated (AutoSert handpiece with MONARCH D cartridge, Alcon) delivery systems. The surgical procedure comprised measuring IOP, creating side port incision, injecting viscoelastic into the anterior chamber, adjusting the volume of viscoelastic in the anterior chamber to reach target IOP reading (15-21mmHg), creating 2.4 mm corneal incision, measuring pre-implantation corneal incision size, delivering the IOL into anterior chamber and measuring the post-implantation incision size.

Pre- and post-incision sizes were 2.38 ± 0.04 mm and 2.50 ± 0.06 mm using the automated delivery device, and 2.38 ± 0.04 mm and 2.53 ± 0.05 mm using the manual delivery device. Wound distortion increase was 0.12 ± 0.04 mm and 0.15 ± 0.06 mm for the automated delivery and manual delivery, respectively. Minimum and maximum wound enlargement values post-IOL implantation were 0.10-0.20 mm. These results are similar to previously reported clinical findings, with wound enlargement values in the range of 0.1 - 0.169 (manual) vs 0.027 - 0.119 (automated) mm.

The human cadaver eye model is a valuable tool for assessing corneal wound enlargement with results showing a similar trend to what has been demonstrated in clinical studies. This model is also useful for testing post-IOL implantation incision sizes of different delivery devices.