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Omar Barrada, MD
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Omar Barrada, MD, shows how to load and insert a multi-piece IOL through a 2.2mm incision. The key to obviating incision enlargement is keeping the leading and trailing haptics extended in the cartridge.
Posted: 5/09/2012
Omar Barrada, MD
Omar Barrada, MD, shows how to load and insert a multi-piece IOL through a 2.2mm incision. The key to obviating incision enlargement is keeping the leading and trailing haptics extended in the cartridge.
Posted: 5/09/2012
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Just Now
Omar Barrada
12 years ago
Boris there is not pressure at the optic-haptic junction as the plunger pushes on the optic alone. Plus those PMMA haptics have very good memory and they usual reattain their shape after being bent.
Boris Ovodenko
13 years ago
The severe pressure at the optic-haptic junction within the smaller cartridge demonstrated in your video can change the haptic angulation and, thus, create an IOL tilt postoperatively, which induces astigmatism. There is a very good chance that this tilt-related astigmatism will be more than 0.5D, which is an average for 2.75mm incision. 2.2mm incision induces 0.3D of astigmatism. I'm not sure it's worth risking a broken or permanently kinked haptic(s) in an attempt to reduce astigmatism from 0.5D to 0.3D. Boris Ovodenko, MD
Omar Barrada
13 years ago
There are IOIs today that are inserted through much smaller incisions ranchump62. Also, Alcons single piece IOls are inserted through these 2.2 incisions. The point is getting these multipiece IOLs in through such small incisions. As i mentioned, if you change your incision site according to where the steep meridian is, then you wont have a problem. But making a 2.65 off the steep axis then you're surely going to increase astigmatism postoperatively. And practicing in the "Refractive Cataract Surgery" era where more and more patients ask for spectacle independance makes a smaller incision a more appealing one.
ari weitzner
13 years ago
i dunno. doesnt look elegant. acrysof lens through a 2.65 looks much nicer and easier on the eye, and the astig is pretty negligible. i think ill wait for a better iol/delivery design before going to 2.2.