Effect of intraocular lens insertion speed on surgical wound structure

To evaluate the difference in the effect of 2 speeds of intraocular lens (IOL) insertion on the clear corneal wound structure.

Ouchi Eye Clinic, Kyoto, Japan.

Prospective randomized clinical trial.

Eyes that had phacoemulsification and Acrysof IQ IOL implantation using a screw-plunger type injector were randomly divided into 2 equally sized groups as follows: Group F, fast IOL insertion (1 revolution per second [rps]) plunger speed, and Group S, slow IOL insertion (¼ rps). The change in wound-size between before IOL insertion and after IOL insertion, need for corneal hydration, surgically induced astigmatism (SIA), and optical coherence tomography (OCT) findings of the corneal wound structure were compared. Comparative laboratory measurements of the cross-sectional surface between empty cartridges and those with an IOL loaded inside were also performed.

Eighty eyes were enrolled. The change in wound size was significantly larger in Group S (P=.002). Corneal hydration was required in 11 of 40 eyes in Group F and in 21 of 40 eyes in Group S (P=.04). Changes in OCT findings were also more prominent in Group S (P=.003). There were no significant differences in SIA. Laboratory examination of the cartridges showed that the vertical diameter of the cross-sectional area was significantly larger when the IOL was loaded than when the cartridge was empty.

When an injector system was used, slow IOL insertion affected clear corneal wound structure more than fast IOL insertion.