Comparison of a new intraocular lens injector system against 3 standard intraocular lens injector systems with different incision sizes: a Miyake-Apple view experimental laboratory study.

Abstract

PURPOSE\nTo compare 1 new intraocular lens injector system against 3 standard injector systems in porcine eyes.\n\n\nSETTING\nDavid J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany.\n\n\nDESIGN\nIn vitro laboratory study.\n\n\nMETHODS\nIn 70 porcine eyes, +20.0 diopter IOLs were implanted with the following systems: multiSert, UltraSert, iTec and RayOne, i.e., S1.8 (incision size: 1.8mm), S2.0 (2.0mm), S2.2P (2.2mm, push-mode), S2.2S (2.2mm, screw-mode), U2.2 (2.2mm), iT2.2 (2.2mm) and R2.0 (2.0mm). Corneal incision sizes were measured before and after implantation with a incision gauge set. Ease of use was evaluated using a Likert scale. IOL delivery time and performance were determined based on Miyake-Apple view videos.\n\n\nRESULTS\nThe incision enlargements were 0.36 ± 0.08mm (S1.8), 0.15 ± 0.07mm (S2.0), 0.17 ± 0.12mm (S2.2P), 0.28 ± 0.10mm (S2.2S), 0.32 ± 0.09mm (U2.2), 0.30 ± 0.08mm (iT2.2) and 0.35 ± 0.11mm (R2.0). Total scores of ease of use were 23.00 (S1.8), 25.00 (S2.0), 29.00 (S2.2P), 26.00 (S2.2S), 26.00 (U2.2), 25.00 (iT2.2) and 24.00 (R2.0). As for the mean delivery time, iT2.2 took the longest time (13.20 ± 3.29 seconds), while S2.2S took the shortest time (4.50 ± 0.71 seconds). Haptic-optic adhesion was observed in S1.8 (4, 40%), S2.2P (2, 20%), U2.2 (5, 50%) and iT2.2 (5, 50%).\n\n\nCONCLUSIONS\nInjector S, with the appropriate incision size and implantation method, could achieve better results regarding incision enlargement, ease of use, delivery time and performance than other injector systems. There was an indirect relationship between incision size and inadvertent events.