Clinical Ophthalmology (Aug 2018)
Comparison of incision size and intraocular lens performance after implantation with three preloaded systems and one manual delivery system
Abstract
Javier Mendicute,1 Thierry Amzallag,2 Lixin Wang,3 Aldo A Martinez4 1Department of Ophthalmology, Hospital Universitario Donostia, San Sebastián, Spain; 2Department of Ophthalmology, Ophthalmic Institute, North of France, Somain, France; 3Ophthalmology Unit, Novartis Pharmaceuticals Corporation, Fort Worth, TX, USA; 4Medical Affairs, Alcon Laboratories, Inc., Fort Worth, TX, USA Purpose: To compare corneal incision size and intraocular lens (IOL) performance/behavior following implantation with the following delivery systems: system U (UltraSert®), system S (Hoya iSert® 250/251), system T (Tecnis® iTec), and a manual system (Monarch® III Delivery System). Setting: Six study sites (four in Spain and two in France). Design: Prospective, multicenter, parallel-group, randomized, subject-masked, postmarket clinical study. Materials and methods: Subjects were enrolled based on predetermined inclusion/exclusion criteria. The effectiveness end points compared corneal incision size and enlargement after IOL implantation (day of surgery) among all delivery systems. Exploratory end points included mean enlargement of corneal incision size, rates of trapped trailing haptic, IOL adherence to the plunger tip, nozzle tip splitting, and mean surgically induced astigmatism (SIA) at postoperative visit. Results: One hundred and nine subjects participated in the study. The mean corneal incision size following IOL implantation was 2.35±0.019 mm for system U, 2.47±0.016 mm for system T, 2.54±0.019 mm for system S, and 2.49±0.011 mm for the manual system. There were five instances of trapped trailing haptic (all system T group, N=26), one instance of IOL adherence to the plunger tip (system S group, N=26), and six instances of nozzle tip splitting (all system S group, N=26). System U had the least SIA (postoperative Day 1) (SIA Centroid = 0.10 diopters [axis: 83.06°]). Conclusion: Preloaded delivery system U supported the completion of surgery with the smallest incision size, the least SIA (postoperative Day 1), and no trapped trailing haptics or nozzle tip splitting compared to two other preloaded systems and one manual system. Keywords: corneal incision, intraocular lens, preloaded IOL injector, UltraSert
