Effect of foldable intraocular lens insertion on incision width

Purpose: To determine whether the surgical incision enlarges during insertion of foldable intraocular lenses (IOLs). Setting: Mackool Eye institute, Astoria, New York. Methods: A variety of IOL insertion devices and foldable and injectable IOLs were inserted through 3.0 or 3.5 mm keratome incisions made in cadaver eyes. The external and internal incision widths were then measured. Results: Each 3.0 mm incision was enlarged externally by 0.10 to 0.65 mm and internally by 0.50 to 0.75 mm by a variety of insertional devices and IOLs. One forceps-IOL combination required a 3.5 mm incision for lens insertion and resulted in a 0.4 mm enlargement of the internal incision. Conclusions: The use of a 3.5 mm incision and insertion devices that do not enlarge an incision of this size might be desirable.