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Incision sizes for foldable intraocular lenses
T Kohnen1, R J Lambert, D D Koch
1Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Houston, Texas, USA.
Ophthalmology
|August 1, 1997
Summary
Foldable intraocular lens (IOL) implantation can enlarge corneal incisions by up to 11%. The smallest post-insertion incision size for a 20.5-diopter IOL is 3.2 mm, with potential for corneal tissue damage.
Area of Science:
- Ophthalmology
- Biomaterials Science
- Surgical Technology
Background:
- Foldable intraocular lenses (IOLs) are crucial for modern cataract surgery.
- Determining optimal incision size is vital for minimizing ocular trauma and ensuring effective lens implantation.
Purpose of the Study:
- To ascertain the minimum incision dimensions for various foldable IOL types.
- To assess the impact of incision size on corneal tissue integrity.
Main Methods:
- A randomized experimental study using 69 human cadaveric eyes.
- Implantation of 8 different foldable IOLs (silicone, acrylic, hydrogel) with varying optic sizes.
- Measurement of incision dimensions pre- and post-implantation; scanning electron microscopy for tissue analysis.
Main Results:
- Post-implantation incision sizes ranged from 3.2 to 3.8 mm.
- Injectors created the smallest initial incisions, but these enlarged by ~11% post-insertion.
- Scanning electron microscopy revealed corneal tissue tearing, more severe with injectors than forceps.
Conclusions:
- Corneal incisions enlarge significantly (up to 11%) after foldable IOL insertion.
- The smallest achievable post-insertion incision for a 20.5-D foldable IOL is 3.2 mm.
- Smaller incisions, particularly with injectors, may increase corneal tissue damage.