Corneal incision architecture after IOL implantation with three different injectors: an environmental scanning electron microscopy study
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To evaluate by Environmental Scanning Electron Microscopy (ESEM) the corneal incision architecture after intraocular lens (IOL) implantation in pig eyes, using manual, automated injectors or preloaded delivery systems.
Twenty-four pig eyes underwent IOL implantation in the anterior chamber using three different injectors: manual (Monarch III) (n = 8), automated (AutoSert) (n = 8), or a preloaded system (UltraSert) (n = 8). Acrysof IQ IOLs, 21 Dioptres (D) (n = 12) and 27D (n = 12), were implanted through 2.2 mm clear corneal incisions. Incision width was measured using corneal calipers. The endothelial side of the incision was analyzed with ESEM.
In each group, the final size of the corneal wound after IOL implantation, measured by calipers, was 2.3–2.4 mm. The incision architecture resulted more irregular in the Monarch group compared with the other injectors. In every group the 27D IOL-implanted specimens showed more alterations than in 21D IOL-implanted samples, and this was less evident in the UltraSert group. The Descemet tear length was higher in the Monarch group than AutoSert and UltraSert group.
The automated and preloaded delivery systems provided a good corneal incision architecture; after high-power IOL implantation the incisions were more regular and less damaged with the preloaded system than with the other devices.
KeywordsCorneal incision Environmental scanning electron microscopy Injector Preloaded injector Intraocular lens Cataract
Compliance with ethical standards
Conflict of interest
David Allen is a paid consultant to Alcon Laboratories. The other authors declare no conflict of interest.
This ex vivo study was conducted on pig cadaver eyes (whole globes), obtained from the abattoir Italpork S.r.l. (Borgo a Buggiano, Italy), and it did not involve live animal subjects; it followed the tenets of the Helsinki Declaration. All applicable international, national, and institutional guidelines for the care and use of animals were followed.