Abstract
PurposeExperimental study to measure the intraocular lens (IOL) injection time and injection speed at different intraocular pressure (IOP) settings when using the AutonoMe® injector.MethodsIn this experimental study, following phacoemulsification in porcine cadaver eyes, a trocar was inserted at pars plana with a connected infusion and IOPs of 20, 50 and 80 mmHg were generated by altering the infusion height. Twelve CO2 gas-driven injectors were used to implant an IOL via a corneal incision of 2.2 mm. For each IOP setting, the duration of the IOL injection and the injection speed was measured by analyzing a video recording of the procedure.ResultsThe mean ±SD injection time (seconds) was 4.47±0.50 at 20 mmHg, 4.98±0.55 at 50 mmHg and 5.47±0.20 at 80 mmHg. The mean ±SD injection speed (millimeters per seconds) was 1.36±0.15 at 20 mmHg, 1.22±0.14 at 50 mmHg and 1.10±0.04 at 80 mmHg.There was a significant (p<0.05) difference between the 20 and 80 mmHg groups in mean injection duration and injection speed.ConclusionThe CO2 gas driven injector allows a safe IOL injection even at elevated IOP. Although the implantation time is slightly extended at higher IOPs, this does not seem to be clinically relevant. No IOL damage was observed at these pressure settings.
Highlights
The development of injectors for lens implantation in cataract surgery has greatly contributed to reducing surgical trauma, by reducing the size of the corneal incision and shortening the surgical procedure time, while maintaining safety.A recent trend is the introduction of preloaded injectors, simplifying lens handling, increasing safety and shortening the implantation time of the intraocular lens (IOL) [1,2]
The implantation time is slightly extended at higher intraocular pressure (IOP), this does not seem to be clinically relevant
Injection time related to intraocular pressure using a CO2 driven preloaded injector
Summary
The development of injectors for lens implantation in cataract surgery has greatly contributed to reducing surgical trauma, by reducing the size of the corneal incision and shortening the surgical procedure time, while maintaining safety.A recent trend is the introduction of preloaded injectors, simplifying lens handling, increasing safety and shortening the implantation time of the IOL [1,2]. In the case of non-preloaded injectors, the IOL must first be inserted into the injector using forceps, a process prone to errors that can lead to damage of the lens or its incorrect insertion in the injector with consequent failure of implantation. Preloaded injectors omit this step and increase the safety of implantation. Injectors with a syringe-like mechanism require more surgical skill for implantation but can be operated with one hand. This is especially advantageous in difficult cases and/local anesthesia cases, where the second hand can be used to stabilize the eye
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