Abstract
Purpose. To compare the final incision size and wound structure after the intraocular lens implantation from 2.0 mm transconjunctival single-plane sclerocorneal incision (TSSI) between the use of a motorized injector at first speed and the use of a manual injector. Methods. Patients were divided into three groups as follows: Group A, a manual injector, Group B, a motorized injector with 0.5 s pause time, and Group C, a motorized injector without pause time. The change in incision size and anterior segment optical coherence tomography findings of the wound structure were analyzed. Results. 110 eyes were enrolled (Group A: 40, Group B: 30, and Group C: 40). The averaged change in incision size (mm) was 0.08, 0.01, and 0.03 in Groups A, B, and C, respectively (p < 0.001). The incision enlargement in Group A was statistically larger compared with other groups (p < 0.01). Descemet's membrane detachments were seen in 26, 9, and 27 eyes one day after the surgery in Groups A, B, and C, respectively (p = 0.001). The rate of Descemet's membrane detachment in Group B was significantly lower than other groups (p < 0.01). Conclusions. The use of a motorized injector by fastest setting with 0.5 s pause time is the best for less wound damage in 2.0 mm TSSI.
Highlights
To date, the techniques for intraocular lens (IOL) implantation have been developed for the reduction of the incision size, because the smaller incisions can offer faster rehabilitation, lesser astigmatism, lesser inflammation, and fewer chances of wound leak and postoperative endophthalmitis after cataract surgery
We used Kruskal-Wallis H test followed by post hoc analysis using Mann-Whitney U test with Bonferroni correction to examine differences in age, endothelial cell density, IOL power, surgical induced astigmatism (SIA), and the incision enlargement among each group
As shown in Results, there were statistically significantly less incision enlargements after IOL implantation through 2.0 mm transconjunctival single-plane sclerocorneal incision using a motorized injector compared with a manual injector in the current study
Summary
The techniques for intraocular lens (IOL) implantation have been developed for the reduction of the incision size, because the smaller incisions can offer faster rehabilitation, lesser astigmatism, lesser inflammation, and fewer chances of wound leak and postoperative endophthalmitis after cataract surgery. The use of an injector system has become a standard technique, and various injector systems have been developed. Previous reports suggested that the construction and enlargement of the main incision are affected by the type of injector cartridges and the method of IOL implantation [1,2,3,4,5]. The surgeon can customize the IOL insertion speed and set a pause time just before the IOL insertion by using this injector. Several reports have already suggested that faster IOL insertion speed can provide less wound enlargement compared to slower IOL insertion speed and that the use of it can offer less wound damage than the manual injector in clear corneal incisions (CCI) [6, 7]. The effects of the pause time on the wound damage have never been evaluated
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