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Corneal Incision Enlargement in Two Preloaded Intraocular Lens Injectors: An Intraindividual In Vivo Study.

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    The iSert injector caused greater corneal wound enlargement during intraocular lens (IOL) implantation than the AutonoMe. However, final incision size and visual outcomes were comparable between the two preloaded IOL injector systems.

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    Area of Science:

    • Ophthalmology
    • Biomedical Engineering
    • Surgical Technology

    Background:

    • Cataract surgery requires precise incision management for optimal visual outcomes.
    • Preloaded intraocular lens (IOL) injectors offer convenience but may impact incision integrity.
    • Understanding injector-induced incision changes is crucial for refractive predictability.

    Purpose of the Study:

    • To compare corneal incision enlargement and functional outcomes after cataract surgery using two different preloaded IOL injectors: AutonoMe and iSert.
    • To evaluate the impact of injector type on surgically induced astigmatism and visual acuity.

    Main Methods:

    • A prospective, randomized, intraindividual comparative study involving 58 paired eyes.
    • Eyes were implanted with either the AutonoMe (Clareon IOL) or iSert (Vivinex IOL) preloaded injector.
    • Corneal incision size was measured pre- and post-surgery; visual acuity and keratometry were assessed at 3 months.

    Main Results:

    • The iSert injector resulted in significantly greater incision enlargement (0.29 ± 0.10 mm) compared to the AutonoMe (0.20 ± 0.10 mm).
    • Final wound sizes were similar (AutonoMe: 2.41 mm, iSert: 2.35 mm).
    • No significant differences were observed in surgically induced astigmatism or 3-month visual acuity between the groups.

    Conclusions:

    • The iSert injector caused more corneal wound enlargement than the AutonoMe during IOL implantation.
    • Despite differences in initial incision enlargement, final incision size and functional visual outcomes were comparable between the AutonoMe and iSert injectors.
    • Both preloaded IOL injectors provide similar functional results in cataract surgery.