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Implantation of a single-piece acrylic intraocular lens using an anterior chamber maintainer. Tomoyuki Kunishige, Hisaharu Suzuki, Toshihiko Shiwa, Hiroshi Takahashi. Nippon Medical School. Authors have no finacial interest. Backgrounds.
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Implantation of a single-piece acrylic intraocular lens using an anterior chamber maintainer Tomoyuki Kunishige, Hisaharu Suzuki, Toshihiko Shiwa, Hiroshi Takahashi Nippon Medical School Authors have no finacial interest.
Backgrounds The ophthalmic viscosurgical devices (OVDs)are now thought to be essential for safe phacoemulsification. However, there are at least 2 concerns regarding OVD use. The first is the intraocular presssure (IOP) elevation after the surgery if the OVD is left in the anterior chamber. The second is the cost of the material because the OVDs are still expensive. If the technique of implanting intraocular lens (IOL) without using OVD is available, it might be helpful to solve these problems.
Purpose To examine a technique for implantation of a single-piece acrylic IOL using an anterior chamber maintainer instead of OVD.
Methods ・Subjects: Male : Female = 3 : 3 (6 eyes) Mean age:76 years ・Methods: After phacoemulsification was performed through a 2.8-mm superior sclerocorneal incision, an anterior chamber maintainer was inserted into the side port at 3 o'clock. The NY-60 IOL was loaded with balanced salt solution (BSS) in the cartridge. While maintaining the anterior chamber depth and the capsular bag by continuous BSS irrigation, the IOL was inserted. All surgeries were performed by a single surgeon.
NY-60 (iMics 1®)HOYA Injector System NY-60 single-piece acrylic IOL Type-N18 cartridge Setting the IOL in the cartridge with BSS
The detail of the procedure Implant the IOL Insert the anterior chamber maintainer The IOL in the capsular bag Fill the cartridge with BSS
Results In all cases, the IOL was smoothly inserted into the capsular bag without causing the collapse of the anterior chamber or the capsular bag. No serious intraoperative or postoperative complications were observed.
Discussion • By using an anterior chamber maintainer, IOL can be inserted safely without using OVD. Also a new IOL cartridge system eliminate the OVD use for IOL setting. Taken together, this method can reduce the risk of the IOP elevation, and lessen the cost of OVD. • One important point is that the IOL should be inserted carefully with checking the stability of the anterior chamber depth.
The technique of IOL implantation into the capsular bag without OVD has been reported. Implantation of a 3-piece silicone intraocular lens using an KS-VFdisposable injector. Shimizu, J Cataract Refract Surg, 2008 Implantation of a single-piece acrylic intraocular lens using an bimanual Irrigation aspiration. Harshul Tak, J Cataract Refract Surg, 2010 • The results of the present study agree with these reports.
Conclusion Using an anterior chamber maintainer, it is possible to implant a single-piece acrylic IOL into the capsular bag safely without using OVD.