In vitro comparison of delivery performance of 4 preloaded intraocular lens injector systems for corneal and sclerocorneal incisions

Abstract

To compare preloaded intraocular lens (IOL) injector systems in porcine eyes. Alcon Japan, Tokyo, Japan. Experimental study. Freshly-excised porcine eyes were assigned to 11 study groups (10 eyes per group) consisting of UltraSert (system U: corneal incisions 2.2mm and 2.4mm), UltraSert long tip (system ULT: corneal incision 2.6mm; sclerocorneal incisions 2.4mm and 2.6mm), iTec (system iT: corneal incisions 2.2mm and 2.4mm; sclerocorneal incisions 2.2mm and 2.4mm), and Vivinex iSert (system iS: corneal incision 2.0mm; sclerocorneal incision 1.8mm). There were a few cases with IOL adherence to the plunger tip, delayed trailing haptic, intrawound manipulation, and damage to IOL, although the occurrence was not confined to particular devices. Cartridge tip splitting was observed with system iS. System U 2.4mm and system ULT 2.6mm caused the least amount of incision enlargement for corneal and sclerocorneal incisions, respectively. System ULT 2.6mm resulted in the largest final size for corneal incisions and sclerocorneal incisions. System iS induced the largest amount of incision enlargement for both incisions but had significantly smaller final incision size than all other systems for corneal incisions and sclerocorneal incisions, except for system U 2.2mm for corneal incisions. Intraocular lens implantation through a tighter incision and with cartridge-insertion technique (>wound-assisted technique) caused greater wound enlargement. A smaller preimplantation incision with a preloaded IOL delivery system did not necessarily result in significantly smaller final incision because of wound enlargement.