Purpose To analyze the effects on corneal morphology of manual, preloaded and automated preloaded IOL injectors in eye bank human corneas by Environmental Scanning Electron Microscopy (ESEM) and in patients after phacoemulsification using Anterior Segment Optical Coherence Tomography (AS-OCT) Settings Eye Clinic, Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Italy Design Retrospective and experimental study Methods A total of 78 corneal incisions after IOL implantation were examined: 30 in human corneas mounted on artificial chamber (ex-vivo study); 48 in patients undergoing phacoemulsification (in vivo analysis). Three different injectors were used: manual (Monarch III, n=26), manual preloaded (Ultrasert=26) and automated preloaded system (Autonome, n=26). Thirty IOLs were implanted in ex-vivo study: 5 intermediate and 5 high dioptric powers for Acrysof IQ (Monarch and Ultrasert) and for Clareon (Autonome) IOLs. In in vivo analysis, 16 corneal wounds for each injector were evaluated using AS-OCT. In ex vivo study incision width was measured; in patients Descemet membrane detachment, posterior wound retraction and posterior gape were analyzed. Results In the eye bank corneas, the incision width was significantly wider in high dioptric power IOL manual subgroup (p<0.05), with more Descemet tearing compared to AutonoMe. In the in vivo study, the incidence of Descemet membrane detachment, posterior gape and wound retraction was lower in the automated preloaded group at 1 postoperative day. Conclusions The automated preloaded injector ensures integrity and safety of the corneal wound also in high-power IOL implantation and in the early postoperative period
Effect of manual, preloaded, and automated preloaded injectors on corneal incision architecture after intraocular lens implantation
2020
Abstract
Purpose To analyze the effects on corneal morphology of manual, preloaded and automated preloaded IOL injectors in eye bank human corneas by Environmental Scanning Electron Microscopy (ESEM) and in patients after phacoemulsification using Anterior Segment Optical Coherence Tomography (AS-OCT) Settings Eye Clinic, Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Italy Design Retrospective and experimental study Methods A total of 78 corneal incisions after IOL implantation were examined: 30 in human corneas mounted on artificial chamber (ex-vivo study); 48 in patients undergoing phacoemulsification (in vivo analysis). Three different injectors were used: manual (Monarch III, n=26), manual preloaded (Ultrasert=26) and automated preloaded system (Autonome, n=26). Thirty IOLs were implanted in ex-vivo study: 5 intermediate and 5 high dioptric powers for Acrysof IQ (Monarch and Ultrasert) and for Clareon (Autonome) IOLs. In in vivo analysis, 16 corneal wounds for each injector were evaluated using AS-OCT. In ex vivo study incision width was measured; in patients Descemet membrane detachment, posterior wound retraction and posterior gape were analyzed. Results In the eye bank corneas, the incision width was significantly wider in high dioptric power IOL manual subgroup (p<0.05), with more Descemet tearing compared to AutonoMe. In the in vivo study, the incidence of Descemet membrane detachment, posterior gape and wound retraction was lower in the automated preloaded group at 1 postoperative day. Conclusions The automated preloaded injector ensures integrity and safety of the corneal wound also in high-power IOL implantation and in the early postoperative periodI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
