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Alan Shan, Guadalupe Villarreal, Allen O Eghrari; Intraocular lens insertion during resident phacoemulsification cases: identification of intraoperative characteristics specific to lens choice. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1160.
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© ARVO (1962-2015); The Authors (2016-present)
Resident physicians training in ophthalmology utilize a variety of intraocular lenses across a minimum of 86 primary cases required for graduation. Supervising physicians would benefit from understanding the intraoperative characteristics of individual lenses, which would allow a precision approach to guidance for each.
To describe the duration and complications encountered during intraocular lens implantation of three models of intraocular lenses (Alcon MA50BM, SA60AT, SN60WF), 120 de-identified cataract surgery video recordings were obtained from a single surgeon and viewed using VLC media player 2.2.4. The “Jump to time (Previous frame) v2.1” VLC add-on was used to record the following time signatures: first incision, lens injector insertion, insertion/removal of tools, and procedure end-time. The type of lens used, the number of adjustments, and the occurrence of intraoperative complications were also recorded. Statistical methods used included one-way ANOVA and Poisson regression.
Mean lens insertion duration was almost three times longer for the MA50BM (75.5s) versus the SA60AT (27.8s) or SN60WF (28.6s). These results were highly significant (p<0.001). However, mean post-insertion adjustment times for the SA60AT (25.0s) and SN60WF (25.1s) were longer than the MA50BM (15.7s), a trend that demonstrated marginal significance (p=0.053). No significant difference was appreciated in lens loading time, mean post-insertion adjustment tool use, or Sinskey hook use among intraocular lens types. Out of 117 completed cases, we noted three with lens ejection difficulties, and two with intraoperative capsule collapse and lens dislocation.
The MA50BM lens was associated with increased insertion time, while the SA60AT and SN60WF required a longer period for post-insertion adjustment, characteristics consistent with the MA50BM’s larger lens and stiffer haptics. Despite slight differences in structure and cartridges used for insertion, the latter two lenses demonstrated similar intraoperative characteristics throughout the study.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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