Posters

Comparison of various disposable injectors and cartridges used for foldable IOLs

Poster Details

First Author: S. Jain INDIA

Co Author(s):    G. Saxena                    

Abstract Details

Purpose:

To compare disposable injectors & cartridges used for implantation of foldable IOLS. Injectors are a critical part of the cataract surgery being responsible for delivering the IOL into the eye which is the only product that stays with the patient and hence the impact of the injector on the safety and efficiency of the procedure is significant.

Setting:

Prospective study carried out at Indira Gandhi Eye Hospital and Research Center, Lucknow, Uttar Pradesh, India. The hospital research ethics committee was consulted regarding our study design and confirmation was given that formal ethics approval was not required. Study Period December 2014 to May 2015.

Methods:

Inclusion criterion: Disposable injectors with disposable cartridges (manually loaded) used in our hospital. Exclusion criteria:1.Reusable injectors with disposable cartridges.2. Pre-loaded injectors.3. Automated IOL delivery system (injectors) Disposable injectors of three manufacturers of i.e. Rayner (I-1), Aurolab (I-2) and Caregroup(I-3)were studied. All IOLs were loaded by the same assistant to reduce error.Equal number of injectors (10) of all three types were tested.Tip diameters and surfaces were compared by the same technician using high magnification photographs.Ease and safety of implantation & predictability of unfolding was judged subjectively by the degree of absence of the difficulties during implantation by the same experienced surgeon.

Results:

The mean Tip diameters were 2.10 mm (I-1),1.96mm(I-2) and 1.80mm(I-3 ) i.e.I-3 has the least diameter and I-1 the maximum diameter.All 3 cartridges are made from polypropylene.Inner surface of all three were smooth.Difficulties during implantation : •Increased resistance during implantation.(0% in I-1, 20% in I-2, and 30%in I-3) •Tilting of IOL into near vertical position while unfolding instead of smooth planar delivery. (0% in I-1 & I-2 and 10% in I-3) •Bubbles disturbing visibility. (0% in I-1 and 20% in I-2 & I-3) •Scratches on IOL surface visible under magnification of operating microscope after IOL implantation. (0% in all three).This shows that ease of implantation & predictability of unfolding was best in I-1, less in I-2 and least in I-3.

Conclusions:

I-3 has least tip diameter & I-1 the most in these 3 injectors.Quality of inner surface of injector & cartridge ensures that no damage to IOL occurs which would affect quality of vision. I-1 has better predictability of unfolding & ease of implantation. However, we need to compare astigmatism due to difference in tip diameters & incision size. We also need to measure the thickness of lenses for the same diopteric power as thicker and hence bulkier lenses require a larger diameter for a smooth and uneventful delivery of the IOL into the eye.

Financial Disclosure:

NONE