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.
Department of Ophthalmology, University of Florida, Gainesville, USA.
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AD
Singh
T
T
Fang
R
R
Rath
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