title: Folding procedure for acrylic intraocular lenses.
abstract: OBJECTIVE
  To compare in vitro the effect of 2 standard methods of folding acrylic intraocular lenses (IOLs) on surface characteristics and bacterial adhesion.
  
  
  METHODS
  Eye Clinic and Department of Health-Microbiology Unit, University of Florence, Florence, Italy.
  
  
  METHODS
  To evaluate the effect of folding, 2 types of acrylic IOLs were not folded or folded with a forceps or an injector and then processed for scanning electron microscopy (SEM) examination. Bacterial adhesion was assessed using an ocular isolate of Pseudomonas aeruginosa. Nonfolded and folded IOLs were placed in test tubes containing the bacterial suspension for direct counting of viable adherent bacteria and for SEM.
  
  
  RESULTS
  The injector-folded IOLs did not show major alterations on the surface; 5 of the 9 forceps-folded IOLs showed marks or scratches in the profile of the optic. The mean number of viable adherent bacteria per area of IOL optic was 1082 (95% confidence interval [CI], 835-1330) in forceps-folded IOLs, 366 (95% CI, 192-359) in injector-folded IOLs, and 206 (95% CI, 123-289) in nonfolded IOLs. Scanning electron microscopy confirmed more surface irregularities on forceps-folded IOLs, with bacteria adherent preferentially on the surface scratches.
  
  
  CONCLUSIONS
  Forceps-folding provoked more surface irregularities, which probably make IOLs more susceptible to bacterial adhesion.
authors.affiliation: Department of Oto-Neuro-Ophthalmological Surgical Sciences-2nd Eye Clinic, University of Florence, Florence, Italy. rita.mencucci@unifi.it
authors.forename: Rita
authors.initials: R
authors.lastname: Mencucci
authors.forename: Rosanna
authors.initials: R
authors.lastname: Dei
authors.forename: Daniele
authors.initials: D
authors.lastname: Danielli
authors.forename: Massimo
authors.initials: M
authors.lastname: Susini
authors.forename: Ugo
authors.initials: U
authors.lastname: Menchini
mesh_terms: D000180:Acrylic Resins; D001422:Bacterial Adhesion; D001672:Biocompatible Materials; D015169:Colony Count, Microbial; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular / Q000382:microbiology*; D008855:Microscopy, Electron, Scanning; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification / Q000502:physiology*; D013499:Surface Properties
chemical_list: D000180:Acrylic Resins; D001672:Biocompatible Materials