title: Acrylic intraocular lens damage after folding using a forceps insertion technique.
abstract: OBJECTIVE
  To analyze intraocular lens (IOL) surface abnormalities seen after folding using a forceps insertion technique.
  
  
  METHODS
  Mayo Clinic, Rochester, Minnesota, USA.
  
  
  METHODS
  Acrylic AcrySof MA60AC IOLs were examined using an Axio Imager microscope before and after they were folded using a forceps insertion technique. Differential interference contrast, brightfield reflected light, and darkfield reflected light imaging techniques were used as necessary. The effects of temperature, time, and ophthalmic viscosurgical device (OVD) on optic surface abnormalities after folding were studied.
  
  
  RESULTS
  All 17 IOLs examined had smooth, defect-free optic surfaces before folding. After folding, anterior optic surface depressions were observed in all IOLs; the depressions corresponded to the contact area of the titanium insertion forceps. Surface depressions were present up to 72 hours after folding, were more pronounced when an insertion forceps with a high degree of wear was used, and were greater when the IOL was warmed to 98 degrees F before folding. Coating the IOL surface with OVD before grasping it with the insertion forceps prevented formation of depressions.
  
  
  CONCLUSIONS
  The anterior optic surface of the acrylic IOL was vulnerable to forceps-induced surface depressions. Surface abnormalities were prevented by coating the anterior optic surface with OVD before grasping it with a metal insertion forceps.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA. erie.jay@mayo.edu
authors.forename: Jay C
authors.initials: JC
authors.lastname: Erie
authors.forename: Brant
authors.initials: B
authors.lastname: Newman
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mahr
authors.forename: Amir R
authors.initials: AR
authors.lastname: Khan
authors.forename: Malcolm
authors.initials: M
authors.lastname: McIntosh
mesh_terms: D019654:Lens Implantation, Intraocular / Q000295:instrumentation*; D007910:Lenses, Intraocular; D008689:Methacrylates; D008857:Microscopy, Interference; D011108:Polymers; D011475:Prosthesis Failure; D013696:Temperature; D013997:Time Factors; D055682:Viscoelastic Substances
chemical_list: D008689:Methacrylates; D011108:Polymers; D055682:Viscoelastic Substances; C104020:poly(methylmethacrylate-co-ethylhexylmethacrylate)