First Author: M.Saeed UK
Co Author(s): K. Ali S. Cazabon
Purpose:
To investigate the incidence and causes of intraocular lens “accidents”.
Setting:
: Department of Ophthalmology, Countess of Chester Hospital, Chester, UK.
Methods:
Retrospective review of theatre register and case notes was performed after appropriate audit and departmental approval. All cases during which more than one intraocular lens was utilized or opened were identified. Notes were then retrieved and reviewed. The model of wasted lens, along with the cause of the wastage (if documented), grade of surgeon, surgical complications, lens defect or problem and IOL exchange (if performed) were noted. A six month period was studied.
Results:
23 lenses were discarded/ wasted in 22 patient episodes during a 6 month period. 1 lens wasted per 33 lenses used was calculated.
In 9 instances, no reason regarding the use of an extra lens was recorded.
Foldable lenses (n=9), injectable intraocular lenses (n=10) and rigid PMMA lens (n=1) had to be discarded due to intraocular lens damage or intra-operative complication and subsequent change in surgical management plan.
The intraocular lenses damaged during insertion included 4 instances of haptic damage, 2 instances of optic damage & 2 instances of unsatisfactory folding. Posterior capsule rupture or zonule dialysis caused 3 lenses to be discarded after opening or implantation & exchange.
Intraocular lens damage was identified after the implantation of the lens in 9 cases. All 9 underwent successful IOL exchange at primary surgery.
Conclusions:
Intraocular lenses may be wasted as a result of unexpected events therefore causing a divergence from the planned surgical procedure. The causes may be diverse and may include a surgical complication necessitating a change in surgical plan and choice of intraocular lens. Our audit shows an improvement in outcomes of utilization and implantation of prosthetic devices implantation in the human eye.
Financial Disclosure:
None
