Incision Sizes for Foldable Intraocular Lenses
Identifieur interne : 009362 ( Main/Merge ); précédent : 009361; suivant : 009363Incision Sizes for Foldable Intraocular Lenses
Auteurs : Thomas Kohnen [États-Unis, Allemagne] ; Richard J. Lambert [États-Unis] ; Douglas D. Koch [États-Unis]Source :
- Ophthalmology [ 0161-6420 ] ; 1997.
Abstract
Objective: The purpose of the study is to determine the minimal incision sizes required for implantation of a variety of different foldable intraocular lenses (IOLs) and to evaluate the effect of incision size on tissue damage.Design: Randomized experimental study.Participants: Sixty-nine fresh human cadaveric eyes: 15 (pilot study), 48 (main study), and 6 (scanning electron microscopy study).Intervention: Implantation of foldable IOLs into cadaveric eyes.Main Outcome Measures: In 48 fresh human cadaveric eyes, limbal corneal tunnel incisions were made, and in a randomized fashion, 8 different foldable IOLs of 20.5 diopters (D) were inserted: 4 silicone (SI-30NB, Allergan Medical Optics, Irvine, CA; C10UB, Chiron Ophthalmics, Inc, Irvine, CA; L141 U, IOLAB, Chiron Ophthalmics, Inc, Irvine, CA; AA-4203, Staar Surgical Company, Monrovia, CA); two soft acrylic (MA60BM and MA30BA, both Alcon Laboratories, Inc, Ft. Worth, TX); and two hydrogel models (SH30BC, Alcon; H60M, Storz Ophthalmics, Inc, St. Louis, MO). For each IOL model, six insertions were performed with a recommended implantation device. Using calipers, the authors measured internal and external incision sizes before and after insertion. Scanning electron microscopy was performed on selected incisions in six additional human cadaveric eyes.Results: Incision sizes after insertion ranged from 3.2 to 3.8 mm. The smallest incisions permitting IOL insertion were associated with the injectors. However, these incisions enlarged after insertion by approximately 11% and then were similar to the incision sizes after forceps insertion of the high-refractive-index silicone, the 5.5-mm optic acrylic, and the one-piece hydrogel IOL. The largest incisions were associated with the 6-mm acrylic IOL and the three-piece silicone IOL with a lower refractive index. The scanning electron microscopy showed tearing of corneal tissue after implantation through the smallest incision; this was more pronounced with injectors than with forceps.Conclusions: Corneal tunnel incisions enlarged up to 11% after insertion of foldable IOLs through the smallest possible incision. With current technology, the smallest postinsertion incision size of a 20.5-D foldable IOL is 3.2 mm.
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DOI: 10.1016/S0161-6420(97)30147-X
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Incision Sizes for Foldable Intraocular Lenses</title><author><name sortKey="Kohnen, Thomas" sort="Kohnen, Thomas" uniqKey="Kohnen T" first="Thomas" last="Kohnen">Thomas Kohnen</name></author><author><name sortKey="Lambert, Richard J" sort="Lambert, Richard J" uniqKey="Lambert R" first="Richard J." last="Lambert">Richard J. Lambert</name></author><author><name sortKey="Koch, Douglas D" sort="Koch, Douglas D" uniqKey="Koch D" first="Douglas D." last="Koch">Douglas D. Koch</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:D068F04F356EE00311CCF853CB8927EAB222482D</idno><date when="1997" year="1997">1997</date><idno type="doi">10.1016/S0161-6420(97)30147-X</idno><idno type="url">https://api.istex.fr/document/D068F04F356EE00311CCF853CB8927EAB222482D/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002521</idno><idno type="wicri:Area/Istex/Curation">002521</idno><idno type="wicri:Area/Istex/Checkpoint">003C11</idno><idno type="wicri:doubleKey">0161-6420:1997:Kohnen T:incision:sizes:for</idno><idno type="wicri:Area/Main/Merge">009362</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Incision Sizes for Foldable Intraocular Lenses</title><author><name sortKey="Kohnen, Thomas" sort="Kohnen, Thomas" uniqKey="Kohnen T" first="Thomas" last="Kohnen">Thomas Kohnen</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Houston</wicri:cityArea></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Johann Wolfgang Goethe-University, Department of Ophthalmology, Frankfurt am Main</wicri:regionArea><wicri:noRegion>Frankfurt am Main</wicri:noRegion><wicri:noRegion>Frankfurt am Main</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Reprint requests to Thomas Kohnen, MD, Johann Wolfgang GoetheUniversity, Department of Ophthalmology, Theodor-Stern-Kai 7, 60590 Frankfurt am Main</wicri:regionArea><wicri:noRegion>60590 Frankfurt am Main</wicri:noRegion><wicri:noRegion>60590 Frankfurt am Main</wicri:noRegion></affiliation></author><author><name sortKey="Lambert, Richard J" sort="Lambert, Richard J" uniqKey="Lambert R" first="Richard J." last="Lambert">Richard J. Lambert</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Alcon Laboratories, Inc, Ft. Worth</wicri:cityArea></affiliation></author><author><name sortKey="Koch, Douglas D" sort="Koch, Douglas D" uniqKey="Koch D" first="Douglas D." last="Koch">Douglas D. Koch</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Houston</wicri:cityArea></affiliation><affiliation><wicri:noCountry code="subField">Inc</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Ophthalmology</title><title level="j" type="abbrev">OPHTHA</title><idno type="ISSN">0161-6420</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1997">1997</date><biblScope unit="volume">104</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1277">1277</biblScope><biblScope unit="page" to="1286">1286</biblScope></imprint><idno type="ISSN">0161-6420</idno></series><idno type="istex">D068F04F356EE00311CCF853CB8927EAB222482D</idno><idno type="DOI">10.1016/S0161-6420(97)30147-X</idno><idno type="PII">S0161-6420(97)30147-X</idno><idno type="ArticleID">30147</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0161-6420</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective: The purpose of the study is to determine the minimal incision sizes required for implantation of a variety of different foldable intraocular lenses (IOLs) and to evaluate the effect of incision size on tissue damage.Design: Randomized experimental study.Participants: Sixty-nine fresh human cadaveric eyes: 15 (pilot study), 48 (main study), and 6 (scanning electron microscopy study).Intervention: Implantation of foldable IOLs into cadaveric eyes.Main Outcome Measures: In 48 fresh human cadaveric eyes, limbal corneal tunnel incisions were made, and in a randomized fashion, 8 different foldable IOLs of 20.5 diopters (D) were inserted: 4 silicone (SI-30NB, Allergan Medical Optics, Irvine, CA; C10UB, Chiron Ophthalmics, Inc, Irvine, CA; L141 U, IOLAB, Chiron Ophthalmics, Inc, Irvine, CA; AA-4203, Staar Surgical Company, Monrovia, CA); two soft acrylic (MA60BM and MA30BA, both Alcon Laboratories, Inc, Ft. Worth, TX); and two hydrogel models (SH30BC, Alcon; H60M, Storz Ophthalmics, Inc, St. Louis, MO). For each IOL model, six insertions were performed with a recommended implantation device. Using calipers, the authors measured internal and external incision sizes before and after insertion. Scanning electron microscopy was performed on selected incisions in six additional human cadaveric eyes.Results: Incision sizes after insertion ranged from 3.2 to 3.8 mm. The smallest incisions permitting IOL insertion were associated with the injectors. However, these incisions enlarged after insertion by approximately 11% and then were similar to the incision sizes after forceps insertion of the high-refractive-index silicone, the 5.5-mm optic acrylic, and the one-piece hydrogel IOL. The largest incisions were associated with the 6-mm acrylic IOL and the three-piece silicone IOL with a lower refractive index. The scanning electron microscopy showed tearing of corneal tissue after implantation through the smallest incision; this was more pronounced with injectors than with forceps.Conclusions: Corneal tunnel incisions enlarged up to 11% after insertion of foldable IOLs through the smallest possible incision. With current technology, the smallest postinsertion incision size of a 20.5-D foldable IOL is 3.2 mm.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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