Incision sizes at different stages of phacoemulsification with foldable intraocular lens implantation

Abstract

To evaluate incision sizes during different stages of phacoemulsification and after implantation of a foldable acrylic intraocular lens (IOL). Private eye center, Manila, Philippines. In this prospective observational case series, incision widths were measured before and after microcoaxial phacoemulsification (2.2 mm), after cortical removal, and after implantation of a 6.0 mm optic, foldable, single-piece aspheric hydrophobic acrylic IOL using a D cartridge and a Monarch III injector. The incision width increased in 101 (93.5%) of the 108 eyes; the enlargement was 0.1 mm in 78 eyes (77.2%) and 0.2 mm in 23 eyes (22.8%). The final incision width was 2.3 mm in 78 eyes (72.2%), 2.2 mm in 27 eyes (25.0%), 2.1 mm in 2 eyes, and 2.4 mm in 1 eye. Enlargement occurred during phacoemulsification in 39 eyes, during cortical removal in 33 eyes, and during IOL implantation in 52 eyes; 23 eyes had more than 1 enlargement. Before IOL implantation, the incision was smaller than 2.2 mm in 76 eyes (70.4%); after IOL implantation, the incision increased to 2.3 mm in 47 eyes (61.8%). Thirty-two eyes (29.6%) had a 2.3 mm incision before IOL implantation; the incision increased further (by 0.1 mm) after IOL implantation in 1 eye. Incision enlargement occurred at different stages of phacoemulsification, mostly during IOL implantation. More than 72% of eyes had a final incision of 2.3 mm. Beginning with a 2.3 mm incision may prevent wound tears and surface irregularities.