Effect of intraocular lens insertion speed on surgical wound structure during phacoemulsification

Abstract

Purpose The purpose of this study was to evaluate the difference in the effect of two speeds of intraocular lens (IOL) insertion on the clear corneal wound structure of two sizes: 2.4 and 2.2 mm. Setting This study was conducted in the Department of Ophthalmology, Faculty of Medicine, Alexandria University, Egypt. Design This is a prospective randomized clinical trial. Patients and methods Eyes that had phacoemulsification and Acrysof IQ IOL implantation using a screw-plunger-type injector were randomly divided into two equal-sized groups as follows. Group A included 40 eyes in which an incision of 2.4 mm size was used. These eyes were randomly divided into two equally sized subgroups: group AF with fast IOL insertion [1 revolution per second (rps)] plunger speed, and group AS with slow IOL insertion (1/4 rps). Group B included 40 eyes in which an incision size of 2.2 mm was used. These eyes were randomly divided into two equally sized subgroups: BF with fast IOL insertion (1 rps) and BS with slow IOL insertion (1/4 rps). The change in wound size before IOL insertion and after IOL insertion, need for corneal hydration, and surgically induced astigmatism were compared. Results The change in wound size was significantly larger in groups AS and BS than in groups AF and BF (P=0.002 and 0.008, respectively). Corneal hydration was required in 35% of cases in group AF and in 65.0% of cases in group AS. In group B, wound hydration was required in 30.0% of cases in group BF and 60% of cases in group BS. The differences were statistically not significant (P=0.057 and 0.736, respectively). Conclusion With an injector system, slow IOL insertion affected clear corneal wound size to a greater extent than fast insertion in the two wound sizes: 2.4 and 2.2 mm.