In Vivo Comparison Of Implantation Behavior And Laboratory Analysis Of Two Preloaded Intraocular Lens Injectors

Published 2022 - 40th Congress of the ESCRS

Reference: FPS01.08 | Type: Free paper

Authors: Isabella Diana Baur* ¹ , Grzegorz Łabuz ¹ , Timur Yildirim ¹ , Lizaveta Chychko ¹ , Tadas Naujokaitis ¹ , Gerd U. Auffarth ¹ , Ramin Khoramnia ¹

¹Heidelberg University Clinic, Dpt. of ophthalmology,Heidelberg,Germany

Purpose

To evaluate quality and duration of intraocular lens (IOL) implantation of two preloaded IOL injectors and assess postimplantation damage.

Setting

This prospective, randomized, comparative study was conducted in a university clinic setting.

Methods

The implantation videos and postuse injectors from 96 paired eyes were included. Patient eyes were randomly assigned for implantation with 2 different preloaded injectors: the AutonoMe with a Clareon IOL (Alcon Laboratories, Inc.) and the Multisert with a Vivinex IOL (Hoya). In the Multisert eyes, the insert shield was used in 23 randomly selected eyes. Videos were reviewed for events during the implantation and the duration of each step. Injector nozzles were examined using light and scanning electron microscopy (SEM). Three months post-surgery IOLs were assessed for material changes.

Results

Mean implantation time was 41.90 ±7.11 s for the multisert injector and 52.22±12.06 s with the AutonoMe injector.

In the AutonoMe group, we observed 4 eyes (8.3%) with a failed docking attempt, 28 eyes (58.3%) with a haptic adherence to the IOL optic, one case (2.1%) of straight leading haptic and 2 cases (4.2%) of intrawound IOL manipulation. There were no events observed in the Multisert group. Implantation was completed in all patients without complications.

Light microscopy and SEM examination revealed cracks of different lengths in all multisert injectors with 64.6% showing short cracks and 18.8 % showing extended cracks. 25% of the AutonoMe injectors showed no damage, 62.5% showed slight deformation and 12.5% moderate deformation.

Conclusions

Both injectors allowed safe and controlled implantation. Implantation time was longer with the AutonoMe injector, mainly due to slower IOL unfolding. With the Multisert injector, implantation behavior was more consistent. None of the events during implantation were clinically relevant for the postoperative outcome. The injectors showed different damage profiles.