Factors Causing Intraocular Lens Damage During Implantation in Phacoemulsification Surgery

Abstract

Aim:To evaluate the factors affecting intraocular lens (IOL) integrity during implantation in phacoemulsification surgery.Materials and Methods:In this study, medical records of 3,856 patients (4,778 eyes) who underwent phacoemulsification and foldable IOL implantation by cartridge between August 2010 and July 2019 were retrospectively reviewed. The 11 eyes of 11 patients who had undergone IOL removal and reimplantation were noted for IOL damage during implantation. In other eyes, implanted IOL material, injector and cartridge type information were recorded.Results:The properties of implanted 4,195 IOLs of 4,778 were hydrophobic acrylic (835 SA60AT, 2,438 AAB00, 922 ZCB00). The remaining 583 IOLs were hydrophobic surfaced high water content acrylic (UD 613). Hydrophobic acrylic IOLs with high water content were inserted with a disposable plastic syringe and foldable cartridge, and hydrophobic acrylic IOLs were inserted with a reusable metal syringe and disposable non-foldable cartridge. Of the 11 IOLs whose integrity was impaired during implantation, 8 were hydrophobic surfaced high water content acrylic and 3 were hydrophobic acrylic (p<0.001). There was no statistically significant difference between hydrophobic acrylic lenses (p=0.103).Conclusion:The material structure of the one-piece hydrophobic surfaced high water content acrylic foldable IOLs, the implantation system and foldable cartridge used are the factors that can potentiate the development of damage in the IOL during implantation. For a problem-free implantation, it should be done carefully and slowly from inserting the IOL into the cartridge until it is placed in the capsule bag.

Keywords

• phacoemulsification
• intraocular lens damage
• intraocular lens exchange