Cartridge cracks during foldable intraocular lens insertion.
OBJECTIVE
To assess the incidence of cartridge cracks during foldable intraocular lens (IOL) insertion and to determine factors that play a role in the development of these cracks.


METHODS
Leesburg Regional Ambulatory Surgical Care Center, Leesburg, Florida, USA.


METHODS
Small incision cataract surgery was performed in 350 consecutive cases. A foldable silicone IOL (Allergan Medical Optics SI-40) was inserted in all cases using the Unfolder cartridge and 3 viscoelastic agents: sodium hyaluronate (Healon, Vitrax) and sodium chondroitin sulfate-sodium hyaluronate (Viscoat).


RESULTS
Cartridge cracks occurred in 52 eyes (14.86%). Almost all cracks (98.1%) occurred in cases in which Healon was used to load the IOL. In each case of a cracked cartridge, there was evidence of the plunger overriding the optic edge.


CONCLUSIONS
We recommend the use of chondroitin-based viscoelastic agents to load the SI-40 foldable IOL to minimize the risk of cartridge cracks. Modifications in the design of the IOL inserter may eliminate the problem of cartridge cracks.
Singh
A D
AD
Department of Ophthalmology, University of Florida, Gainesville, USA.
Fang
T
T
Rath
R
R
D002809:Chondroitin Sulfates; D006801:Humans; D006820:Hyaluronic Acid; D015994:Incidence; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular / Q000009:adverse effects* / Q000295:instrumentation*; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D012826:Silicone Elastomers
D012826:Silicone Elastomers; D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates