Intraocular Lens Delivery Characteristics of the Preloaded AcrySof IQ SN60WS/AcrySert Injectable Lens System

Abstract

To evaluate the delivery characteristics of the AcrySof IQ SN60WS intraocular lens (IOL) injected via a preloaded AcrySert delivery system. Prospective observational case series. setting: This study was carried out in the cataract service of an ophthalmic hospital that serves a large sector of inner-city London. patient population: The study included all patients undergoing routine phacoemulsification procedures with implantation of the SN60WS IOL via the preloaded system over 5 consecutive months. A total of 85 patients (85 eyes) were included in this study. intervention: Phacoemulsification procedures conducted by 7 surgeons were digitally captured. outcome measures: Video recordings of the IOL delivery stage were analyzed by a single observer. Of particular interests were the orientation of the leading haptic and optic on insertion, the degree of intrawound manipulation of the injector, and the time required to satisfactorily deliver the IOL into the capsular bag in a correct orientation. Problems of IOL delivery were also noted. In 38 out of 85 eyes (45%), correct IOL delivery behavior was achieved with the leading haptic orientating to the left of the surgeon and thus did not require any intrawound rotational manipulation of the injector. Forty-seven of the 85 eyes (55%) required additional rotational manipulation of IOL orientation. Other problems recorded were trapped trailing haptic, haptic-optic adhesion, overriding of the plunger over the optic, and trauma to optic edge. The average time to achieve satisfactory IOL position was 47 seconds. IOL power and the grade of the operating surgeon did not appear to influence the event of a misdirected leading haptic. The AcrySof SN60WS/AcrySert system does not appear to meet the expectations of pro-viding a predictable means of IOL delivery.