Comparative assessment of the corneal incision enlargement of 4 preloaded IOL delivery systems

Purpose: To compare the corneal incision size enlargement after intraocular lens (IOL) implantation of a new, automated, preloaded delivery system, AutonoMe (system A), vs that of 3 other available preloaded systems (UltraSert [system U], Vivinex iSert [system V], and Tecnis iTec [system T]). Setting: Alcon Vision LLC, Fort Worth, Texas, USA. Design: Experimental study. Methods: Human cadaver eyes were randomly assigned to receive IOLs implanted with the preloaded delivery devices. Corneal incisions were imaged using optical coherence tomography, and incision sizes were measured using an Asico incision gauge before and after IOL delivery. Differences in mean incision enlargement between delivery devices were evaluated using a paired t test. Results: System A (mean +/- standard deviation, 0.29 +/- 0.03 mm) and system U (0.29 +/- 0.03 mm) had the smallest mean incision size enlargement compared with system T (0.31 +/- 0.03 mm) and system V (0.36 +/- 0.06 mm). System V had the largest corneal incision enlargement and was significantly larger than system A (P =.001), system U (P =.001), and system T (P =.002). System A was noninferior to system U; the paired difference in corneal incision enlargement between the devices was similar to 0.01 +/- 0.04 mm (90% CI, similar to 0.03 to 0.01). Conclusions: The new system A preloaded delivery system provided smaller corneal incision enlargement compared with system T or system V and was noninferior to system U. Copyright (C) 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.