6.5 mm optic AcrySof implantation through a 3.0 mm incision

An Alcon AcrySof MA50BM intraocular lens (IOL) with an optic diameter of 6.5 mm can be implanted without further enlarging a 3.0 mm phacoemulsification incision. The IOL is placed in a Monarch II B cartridge (Alcon) designed for use with the 5.5 mm optic AcrySof SA30AL, and the tip of the cartridge is inserted in the incision but not the anterior chamber. With the cartridge tip pressing against the eye, holding up the inner edge of the corneal incision and pressing down on the outer edge of it, the plunger is advanced to insert the IOL. When the entire optic has been inserted in the eye, the cartridge is withdrawn and the trailing loop is tucked in the capsular bag. We have used this procedure to perform uneventful IOL implantation in 228 consecutive eyes, after which the incisions were 3.0 to 3.1 mm in width.