Alterations to the AcrySof intraocular lens during folding

Abstract

Purpose: To determine the frequency and cause of scratches or marks on the AcrySof intraocular lens (IOL).

Setting: Centre SaintVictor, Amiens Cédex, France.

Methods: In a clinical study, an AcrySof IOL was implanted in four eyes using a McDonald-Livernois forceps. In an experimental study, 50 sterile AcrySof IOLs were folded under a surgical microscope by one person; 40 were folded with a modified Steinert forceps and 10, with a modified Buratto forceps.

Results: Three IOLs implanted in the clinical study had scratches, marks, or both. These were noted during surgery but were not significant enough to justify explantation. They had no effect on recovery of vision. Of the 50 IOLs studied microscopically, 18 showed no defects; 32 had some alterations that were difficult to assess because they were minimal or because more than one alteration appeared on the same lens.

Conclusion: AcrySof IOLs are more fragile than silicone IOLs, although the alterations caused by folding did not affect visual acuity in this study. To avoid complications, the lens must be folded on the 6 to 12 o'clock axis and the haptics inserted one right after the other.