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Corneal incision architecture after IOL implantation with three different injectors: an environmental scanning electron microscopy study

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Eye Clinic, Department of Surgery and Translational Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Rita Mencucci & Eleonora Favuzza

  2. Electron Microscopy Centre “Laura Bonzi” (Ce.M.E.), ICCOM, CNR, Sesto Fiorentino, Florence, Italy

    Maria Cristina Salvatici

  3. Department of Biotechnology and Medical-Surgical Sciences, “Sapienza” University of Rome, Rome, Italy

    Leopoldo Spadea

  4. Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, UK

    David Allen

Authors
  1. Rita Mencucci
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  2. Eleonora Favuzza
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  3. Maria Cristina Salvatici
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  4. Leopoldo Spadea
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  5. David Allen
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Corresponding author

Correspondence to Rita Mencucci.

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Conflict of interest

David Allen is a paid consultant to Alcon Laboratories. The other authors declare no conflict of interest.

Ethical approval

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.

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Mencucci, R., Favuzza, E., Salvatici, M.C. et al. Corneal incision architecture after IOL implantation with three different injectors: an environmental scanning electron microscopy study. Int Ophthalmol 39, 397–403 (2019). https://doi.org/10.1007/s10792-018-0825-2

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  • DOI: https://doi.org/10.1007/s10792-018-0825-2

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